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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 3953-3959
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3953
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3953
Differentiation of acute and chronic hepatitis B in IgM anti-HBc positive patients
Ji Won Park, Sung Eun Kim, Choong Kee Park, Department of Internal Medicine, Hallym University Medical Center, Anyang 431-070, South Korea
Kyeong Min Kwak, Department of Occupational and Environmental Medicine, Hallym University Medical Center, Anyang 431-070, South Korea
Myoung Kuk Jang, Myung Seok Lee, Hyoung Su Kim, Department of Internal Medicine, Hallym University Sacred Heart Hospital of Hallym University Medical Center, Seoul 134-701, South Korea
Dong Joon Kim, Department of Internal Medicine, Hallym University Medical Center, Chuncheon 200-704, South Korea
Author contributions: Kim HS and Park CK designed the research; Park JW, Kim SE, Jang MK, Kim DJ and Lee MS performed the research; Park JW, Kwak KM and Kim HS analyzed the data; Park JW wrote the paper.
Supported by Hallym University Medical Center No. HURF-2013-31.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hyoung Su Kim, MD, Department of Internal Medicine, Hallym University Sacred Heart Hospital of Hallym University Medical Center, 445, Gildong, Kangdong-gu, Seoul 134-701, South Korea. hskim@hallym.or.kr
Telephone: +82-2-22252889 Fax: +82-2-4786925
Received: August 16, 2014
Peer-review started: August 17, 2014
First decision: September 15, 2014
Revised: October 7, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: April 7, 2015
Peer-review started: August 17, 2014
First decision: September 15, 2014
Revised: October 7, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: April 7, 2015
Core Tip
Core tip: Distinguishing between acute hepatitis B (AHB) and chronic hepatitis B with acute exacerbation (CHB-AE) is important because of the different prognosis and treatment strategy. However, distinguishing AHB and CHB-AE is difficult due to their similar clinical features and serologic profiles, especially in patients with IgM anti-HBc positivity. This is the first study to differentiate between AHB and CHB-AE in a distinct group of subjects with positive IgM anti-HBc. The quantitative determination of IgM anti-HBc was useful for differentiating AHB from CHB-AE in patients IgM anti-HBc positive. The combination of serum IgM anti-HBc ≥ 8 S/CO ratio with HBV-DNA levels < 5.5 log10 IU/mL could effectively distinguish AHB from CHB-AE.