We studied IgG and IgM antibodies to hepatitis C virus core protein (a
nti-HCVcore) in relation to serum virus RNA levels in 71 hepatitis C v
irus carriers. Viremic levels ranged from 10(4)-10(9) copies/ml and we
re high in 34 chronic active hepatitis patients compared with 17 asymp
tomatic carriers and 20 cases of chronic persistent hepatitis (p<0.01)
. IgG anti-HCVcore was found in 67/71 (94%), but four asymptomatic car
riers with low levels of viremia (10(4)-10(55) copies/ml) tested negat
ive. IgM anti-HCVcore was found in patients with high levels of viremi
a (10(8)-10(9) copies/ml), and one (6%) asymptomatic carrier and nine
(26%) chronic active hepatitis patients tested positive. In chronic he
patitis patients, viremic levels were significantly higher in cases po
sitive for IgM anti-HCVcore than in negative ones (p<0.01). However, n
o correlation was found between the occurrence of IgM anti-HCVcore and
serum aminotransferase levels or the histologic activity index. These
findings suggest that although IgG anti-HCVcore is sensitive, low vir
emic patients can escape this screening, and that the IgM anti-HCVcore
is induced in association with high levels of virus replication. (C)
Journal of Hepatology.