To evaluate diagnostic improvement achieved with the determination of antibody to hepatitis core antigen of the IgM type (anti-HBc-IgM) and antibody to delta antigen (anti-HD) in acute type B hepatitis, 155 patients (of whom 100 were drug addicts) were studied, using these markers in association with the classical markers of viral hepatitis (anti-HBc, anti-HBs, anti-HAV-IgM and anti-cytomegalovirus antibodies). With classical diagnostic criteria, 121 patients would have been diagnosed as having hepatitis B (HBs Ag and/or anti-HBc antibody positive without anti-HBs antibody), 33 non A non-B hepatitis (all markers negative or anti-HBc and and anti-HBs positive) and 3 hepatitis A (anti-HAV-IgM antibody positive). With the current markers, 89 were hepatitis B (anti-HBc-IgM antibody positive), 18 were simultaneous B and D infections (anti-HBc-IgM and anti-HD antibodies positive), 6 were hepatitis D (anti-HBc-IgM antibody negative and anti-HD antibody positive), 39 non-A non-B hepatitis (anti-HBc-IgM, anti-HD, HAV-IgM and anti-cytomegalovirus antibodies negative) and 3 hepatitis A. Of the 121 cases initially diagnosed as hepatitis B, only 79 were actually hepatitis B, 16 were simultaneous B and D infections, 6 hepatitis D, 18 non-A non-B hepatitis and 2 hepatitis A. Of the 33 cases considered to be non A non-B hepatitis, only 21 were really non-A non-B hepatitis; 10 were hepatitis B and 2 hepatitis B and D. When anti-HBc-IgM and anti-HD antibodies were determined, the initial diagnosis was modified in 54 of 155 cases (35%). The use of these serum markers substantially improves the etiologic diagnosis of acute viral hepatitis.
|Journal||Gastroenterologie Clinique et Biologique|
|Publication status||Published - 1 Dec 1986|