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Higher cut‐off index value of immunoglobulin M antibody to hepatitis B core antigen in Taiwanese patients with hepatitis B
Author(s) -
Huang YiWen,
Lin ChihLin,
Chen PeiJer,
Lai MingYang,
Kao JiaHorng,
Chen DingShinn
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04280.x
Subject(s) - medicine , hepatitis b , antibody , gastroenterology , acute hepatitis b , immunoglobulin m , immunology , hepatitis , immunoglobulin g , hepatitis b virus , hbsag , virus
Background: The cut‐off index value of immunoglobulin M (IgM) antibody to hepatitis B core antigen (anti‐HBc; AxSYM CORE‐M, Abbott) for diagnosing acute hepatitis B is 1.2. A high false‐positive rate of IgM anti‐HBc was observed in acute flare‐ups of chronic hepatitis B in Taiwanese patients. Thus the purpose of the present paper was to study the optimal index value of IgM anti‐HBc in Taiwanese subjects. Methods: The peak index values of 42 IgM anti‐HBc‐positive patients were collected. There were 20 acute hepatitis B patients and 22 patients with chronic hepatitis B with acute flare. The biochemical, virological, and serological data were obtained. Results: There were significant differences in mean age (36 vs 47 years, P = 0.01), serum alanine aminotransferase level (2042 U/L vs 1193 U/L, P = 0.02) and peak index value of IgM anti‐HBc (2.9 vs 1.5, P < 0.01) between patients with acute hepatitis B and those with acute flare of chronic hepatitis B. Eleven (50%) of 22 patients with chronic hepatitis B with acute flare had index value of >1.2. The optimal cut‐off index value to differentiate acute hepatitis B from chronic hepatitis B with acute flare was 2.4–2.5, with a sensitivity of 90% and specificity of 90%. Conclusions: The cut‐off index value of IgM anti‐HBc to differentiate acute hepatitis B from chronic hepatitis B with acute flare among Taiwanese patients should be set at 2.4–2.5 instead of 0.8–1.2.