IgM antibody to hepatitis B core antigen (anti-HBc IgM) in "healthy" HBsAg carriers: a longitudinal study of 75 cases.

In 75 healthy HBsAg carriers with normal liver tissue who were followed over a four years period, anti-HBc IgM was determined by ELISA. 61 HBsAg carriers (81%) were positive for anti-HBc IgM at first investigation. 54 individuals demonstrated persistence of anti-HBc IgM, 7 became anti-HBc IgM-negative within the observation period. 12 persons were persistent anti-HBc IgM of low quantities. 3 of 4 individuals with HBsAg clearance demonstrated a considerable decrease of anti-HBc IgM concentration. Although signs of liver damage or development of chronic liver diseases were not observed at the time of control biopsy the existence of anti-HBcIgM indicates that there exists also in healthy HBsAg carriers a persistent stimulation by HBcAg, inducing the production of anti-HBc IgM as a sign of permanent ongoing virus B replication. These results require a new and critical review of the "healthy" HBsAg carrier state.