Viral specific IgM antibody has been detected in most acute viral infections and is a reliable marker of acute disease. The concentrations of anti-HBc IgM rise rapidly in patients with acute infection; high levels of anti-HBc IgM have been detected in patients with acute hepatitis B viral infection. Hepatitis B surface antigen
(HBsAg) will generally also be present as a serological marker of an acute infection, but there are reports of HBsAg being undetectable.
In the convalescent phase, anti-HBc IgM will persist after the disappearance of HBsAg and decrease slowly over time. In the absence of information about any other hepatitis B virus (HBV) markers, it must be considered that an individual with detectable levels of anti-HBc IgM may be actively infected with HBV or that the infection may have resolved. Anti-HBc IgM may also be present in patients with chronic hepatitis B viral infection. The concentrations are generally lower than those associated with acute infections and may rise and fall with exacerbation of the disease. 5 Differentiation of acute and chronic hepatitis B viral infection solely on the basis of viral markers, which are also frequently present, such as HBsAg, anti-HBs, HBeAg, anti-HBe,
and anti-HBc, is difficult because most of these markers occur in both acute and chronic disease. Since there is high correlation of high antiHBc IgM concentrations with acute hepatitis B viral infection, the test for anti-HBc IgM may serve as an aid to distinguish acute hepatitis illness due to HBV versus superimposed infections by other possible agents such as hepatitis A, hepatitis C, or delta virus.
Manufacturer’s reagent package insert, Architect Anti-HBc IgM, December 2017, Abbott GmbH & Co. KG, Max-Planck-Ring 2, Wiesbaden, Germany.