HEMOLYSIS IN HEPATITIS-A VIRUS-INFECTIONS COINCIDING WITH THE OCCURRENCE OF AUTOANTIBODIES AGAINST TRIOSEPHOSPHATE ISOMERASE AND THE REACTIVATION OF LATENT PERSISTENT EPSTEIN-BARR-VIRUS INFECTION

Haemolysis has been observed frequently as a complication of acute hep atitis A virus (HAV) infection. However, the pathogenic mechanism has not been elucidated completely, In individual cases the detection of a nti-erythrocyte antibodies of unknown specificity was described. The r aised serum IgM fraction was shown to consist partially of autoantibod ies. Previously, we detected autoantibodies of immunoglobulin class M directed against triosephosphate isomerase (IgM anti-TPI) in patients with infectious mononucleosis. These autoantibodies are able to induce haemolysis. In this study the occurrence of IgM anti-TPI in acute HAV infections and other viral diseases has been investigated. In 33 of 1 34 patients suffering from HAV infection (IgM anti-TPI was detected. H aematological and chemical data were available from seven of these 33 patients. Mild-to-moderate signs of haemolysis correlating with the Ig M anti-TPI titre in the follow-up examinations were demonstrated. The presence of IgM anti-TPI in HAV infections is connected with a reactiv ation of a talent persistent EBV infection. In other viral infections both the detection of IgM anti-TPI and evidence of a reactivated EBV i nfection is rare. Thus, we anticipate that IgM anti-TPI antibodies occ urring with the reactivation of a latent persistent EBV infection take part in provoking haemolysis in acute HAV infections. (C) 1996 Wiley- Liss, Inc.