Semiquantitative anti‐HBc IgM detection in children with chronic hepatitis B: A long‐term follow‐up study

Serum anti‐HBc IgM titres were monitored monthly by a semiquantitative method in 14 children with HBeAg positive chronic hepatitis B followed up for 18‐65 months. All patients, but one, were treated with alfa‐interferon (IFN) at different times. On the whole, 12 flare‐up episodes were observed and 7 patients cleared HBV‐DNA and seroconverted to anti‐HBe. Seroconversion occurred only in patients with pretreatment anti‐HBc IgM index greater than 0.15 and serum HBV‐DNA concentration below 100 pg/ml; the pretreatment alanine aminotransferase (ALT) value was not predictive of response. Combining anti‐HBc IgM results and serum HBV‐DNA levels observed during the pre‐IFN period allowed a precise identification of patients who were likely to respond to IFN therapy. Patients who seroconverted to anti‐HBe showed a progressive reduction in serum anti‐HBc IgM titres within 6 months. Interestingly, one child, in whom HBV‐DNA reappeared andwho reconverted to HBeAg 7 months after treatment, showed no anti‐HBc IgM decrease afterthe transient clearance of HBV‐DNA and anti‐HBe seroconversion. Semiquantitative anti‐HBcIgM detection is a useful tool in the decision making process for children with chronic hepatitis B. © 1995 Wiley‐Liss, Inc.