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| ORIGINAL ARTICLES |
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| Optimal time for repeating the IgM anti-hepatitis A virus
antibody test in acute hepatitis A patients with
a negative initial test |
| Jong Jin Hyun1, Yeon Seok Seo1, Hyonggin An2, Sun Young Yim1, Min Ho Seo1, Hye Sook Kim1,
Chang Ha Kim1, Ji Hoon Kim1, Bora Keum1, Yong Sik Kim1, Hyung Joon Yim1, Hong Sik Lee1,
Soon Ho Um1, Chang Duck Kim1, and Ho Sang Ryu1 |
| Departments of 1Internal Medicine and 2Biostatistics, Korea University College of Medicine, Seoul, Korea |
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Corresponding Author:
Yeon Seok Seo ,Tel: +82-2-920-6608, Fax: +82-2-953-1943, Email: drseo@korea.ac.kr |
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| ABSTRACT |
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| 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 ¡Ã400 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 (¥â=-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. |
| Keywords: Acute hepatitis A; IgM anti-HAV; Alanine aminotransferase |
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