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Anti HAV IgM nonreactive, IgG reactive but showing present symptoms of Hep A
Feb 2, 2014

Hello, my four year old is presently showing symptoms of Hep A like yellow eyes and skin, dark yellow urine. Lab tests showed high bilirubin and urobilinogen. What stumping is his Anti HAV IgM is nonreactive and the Anti HAV IgG is reactive. He had his last Hep A vaccine October 2013. Please help provide answer to this mystery.

Response from Dr. Young

Hello and sorry to hear about your son.

His symptoms and lab work are consistent with hepatitis- namely irritation of the liver. What is causing the liver irritation is the key question.

Viral hepatitis is a possibility, though his current lab tests are indicative of hepatitis A infection in the past (a positive IgG), rather than acute hep A (when IgM tests are positive). Indeed, his tests tell us that the vaccine that he had in October actually worked and produced protective antibodies.

Something other than hepatitis A virus infection- perhaps a different virus, or toxin (or toxicity) is the cause.

Hope that helps and that your son gets well soon. BY



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