Anti-HCV-core specific IgM in porphyria cutanea tarda

Aim: Analysis of the prevalence of serum IgM antibodies directed against the HCV-core antigen (HCV-IgM) in patients with Porphyria cutanea tarda (PCT), taking into account the hepatic histological picture, liver biochemical markers and the PCT biochemical indices. Background: Hepatic damage, especially that due to HCV infection, has been previously reported as a PCT trigger. HCV-IgM reactivity, a marker of chronic HCV hepatitis, suggested to be related to active virus replication could also be related to the PCT clinical course. Methods: Blood samples of 97 patients, previously analyzed for a panel of clinical, histological and laboratory variables, followed in our Centre for Porphyria, stored at -80°C, were available to be retrospectively assayed for anti-HCV-core IgM (HCV-IgM, ELISA). Results: 61% HCV-IgM positivity was found, with no apparent significant relationship with the respective histological hepatitis classification, PCT remission phase, and PCT familiarity, when evaluated on overall patients. The levels of HCV-IgM presented a peculiar behaviour when correlated to the serum AST values. In fact, there was a significant positive correlation in those with HCV-IgM <4 and a not significant, inverse correlation in the remaining group. These two groups showed other differences: the HCV-IgM levels were correlated to histology, PCT remission and to the markers of liver disease (such as AST and ALT) only in the first group. Conclusion: a relationship between IgM response, PCT activity and the underlying liver disease is suggested.