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Increased IgM class circulating immune complexes in acute hepatitis A virus infection
J F Tsai1, H S Margolis, J E Jeng
1Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Insights
Circulating immune complexes (CIC) are common in acute hepatitis A, with IgM-specific CIC being predominant. These IgM CIC levels correlate with disease activity, suggesting a role in hepatitis A pathogenesis.
Area of Science:
- Immunology
- Hepatology
- Virology
Background:
- Acute hepatitis A is a significant public health concern.
- The role of immune responses, specifically circulating immune complexes (CIC), in hepatitis A pathogenesis requires further elucidation.
Purpose of the Study:
- To assess the role of IgM- and IgG-specific CIC in acute hepatitis A.
- To investigate the correlation between CIC levels and disease activity markers.
Main Methods:
- Quantified IgM- and IgG-specific CIC using C1q and conglutinin (K) assays.
- Analyzed data from 205 patients with acute hepatitis A and 60 healthy controls.
Main Results:
- CIC were prevalent in 95.6% of acute hepatitis A patients, significantly higher than in controls (P=0.0001).
- IgM-specific CIC were more prevalent than IgG-specific CIC.
- Higher IgM CIC levels correlated inversely with symptom onset to presentation interval and positively with alanine aminotransferase levels and jaundice.
Conclusions:
- IgM-specific CIC are the predominant type in acute hepatitis A.
- CIC, particularly IgM class, are associated with disease activity and may contribute to hepatitis A pathogenesis.
Abstract:
For assessing the role of circulating immune complexes (CIC) in acute hepatitis A, IgM- and IgG-specific CIC were determined, by C1q and conglutinin (K) assays, in 205 patients with acute hepatitis A and 60 healthy controls. The concentration of each type of CIC in patients was higher than healthy controls (P=0.0001). CIC was a common feature of acute hepatitis A with 95.6% of cases having at least one abnormal test result. The prevalence of abnormal IgM class CIC was significantly higher than IgG class CIC. There were significantly inverse correlations between levels of IgM class CIC and interval between onset of symptoms and patient presentation. The prevalence of abnormal IgM CIC was higher in patients with higher alanine aminotransferase (P=0.001) and patients with jaundice (P=0.0002). In conclusion, IgM class CIC is the predominant CIC in acute hepatitis A and correlated with disease activity. CIC may play a role in the pathogenesis of acute hepatitis A.