Oligoclonal immunoglobulin bands in serum in association with chronic viral hepatitis.

We studied serum immunoglobulins in 54 patients with chronic viral hepatitis. The majority had hyperglobulinemia, with immunoglobulin G (IgG) being elevated the most. High resolution protein electrophoresis revealed the presence of oligoclonal bands within the gamma-globulin region of the electrophoretic pattern (oligoclonal immunoglobulin bands) in 32 (59%) patients. Between two and seven bands were noted in each sample. In order to analyze the significance of this observation, we performed stepwise discriminant analysis of clinical, demographic, serological, and serum biochemical features in patients with and without detectable oligoclonal immunoglobulin bands. The patient's ages and serum immunoglobulin G levels were found to be important predictors of the presence of oligoclonal immunoglobulin bands. No correlation was found with the type of hepatitis, disease severity, or duration of hepatitis. On follow-up, serum samples were retested in 20 patients, over 5 to 60 months. Significant change was noted in only one patient in whom oligoclonal immunoglobulin bands (initially very prominent) became progressively weaker and finally disappeared over a 5-yr period. This was associated with an improvement in his hepatitis after loss of hepatitis following loss of hepatitis B e antigen from serum. These observations suggest that the determination of oligoclonal immunoglobulin bands in serum may be a useful marker to study the course and activity of chronic viral hepatitis in selected patients.