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IgM anti‐HBc in anti‐HBe positive chronic type B hepatitis with acute exacerbations

IgM anti‐HBc was measured by radioimmunoassay in serially collected serum samples during 20 acute exacerbations which developed in 14 patients with anti‐HBe positive chronic type B hepatitis. IgM anti‐HBc became positive in 12 of the 14 (86%) patients and in 18 of the 20 (90%) exacerbations, and elevation of IgM anti‐HBc which was believed to be significant was also observed in the remaining two patients. In most of the patients who also had determinations of serum hepatitis B virus DNA, the hepatitis B virus DNA became positive. These results suggest that ALT elevation in anti‐HBe positive chronic type B hepatitis is associated with active replication of hepatitis B virus. It is considered to be useful to measure IgM anti‐HBc for the purpose of identifying the causes of ALT elevation in anti‐HBe positive chronic type B hepatitis.