Optimal time for repeating the IgM anti-hepatitis A virus antibody test in acute hepatitis A patients with a negative initial test.
10.3350/kjhep.2012.18.1.56
- Author:
Jong Jin HYUN
1
;
Yeon Seok SEO
;
Hyonggin AN
;
Sun Young YIM
;
Min Ho SEO
;
Hye Sook KIM
;
Chang Ha KIM
;
Ji Hoon KIM
;
Bora KEUM
;
Yong Sik KIM
;
Hyung Joon YIM
;
Hong Sik LEE
;
Soon Ho UM
;
Chang Duck KIM
;
Ho Sang RYU
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. drseo@korea.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute hepatitis A;
IgM anti-HAV;
Alanine aminotransferase
- MeSH:
Acute Disease;
Adult;
Alanine Transaminase/blood;
Female;
Hepatitis A/*diagnosis;
Hepatitis A Antibodies/*blood;
Hepatitis A virus/*immunology;
Humans;
Immunoglobulin M/*blood;
Male;
Odds Ratio;
Retrospective Studies;
Time Factors
- From:The Korean Journal of Hepatology
2012;18(1):56-62
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The nonspecific clinical presentation of acute hepatitis A (AHA) mandates the detection of anti-hepatitis A virus IgM antibodies (IgM anti-HAV) in the serum for obtaining a definitive diagnosis. However, IgM anti-HAV might not be present during the early phase of the disease. The aim of this study was to determine the optimal time for repeating the IgM anti-HAV test (HAV test) in AHA patients with a negative initial test. METHODS: In total, 261 patients hospitalized with AHA were enrolled for this retrospective study. AHA was diagnosed when the test for IgM anti-HAV was positive and the serum alanine aminotransferase (ALT) level was > or =400 IU/L. Repeat HAV test was conducted after 1-2 weeks if the initial HAV test was negative but AHA was still clinically suspected. RESULTS: The results of the initial HAV test were negative in 28 (10.7%) patients. The intervals from symptom onset to the initial-HAV-test day and from the peak-ALT day to the initial-HAV-test day were significantly shorter in the negative-initial-HAV-test group, but on multivariate analysis only the latter was significantly associated with negative results for the initial HAV test (beta=-0.978; odds ratio [95% confidence interval]=0.376 [0.189-0.747]; P=0.005). The HAV test was positive in all patients when it was performed at least 2 days after the peak-ALT day. CONCLUSIONS: The results of HAV tests were significantly associated with the interval from the peak-ALT day to the HAV-test day. The optimal time for repeating the HAV test in clinically suspicious AHA patients with a negative initial HAV test appears to be at least 2 days after the peak-ALT day.
