Circulating HBsAg/IgM complexes in acute and chronic hepatitis B

Complexes between HBsAg and IgM have recently been described in the sera of HBsAg carriers. A solid phase RIA for HBsAg/IgM complexes has been described. Fifteen patients with acute viral hepatitis type B, and 52 HBsAg chronic carriers were studied. Testing of serial sera in acute hepatitis patients revealed that HBsAg/IgM complexes disappeared (preceding HBsAg negativization and usually at the same time as seroconversion from 'e' to 'anti'e') with 4 weeks in all but one patient who became a chronic HBsAg carrier. In addition, HBsAg/IgM complexes were found in 48% of HBsAg chronic carriers, in 69% of CPH patients, but in only 20% of healthy carriers (p < 0.005). Although complexes were detectable in 93% HBeAg positive chronic carriers, they were also frequently found in anti-HBe positive patients, but never in e/anti-e negative patients (p < 0.001). HBsAg/IgM complexes seem to be of important prognostic and diagnostic value in acute and chronic hepatitis B.