Hepatitis B virus infection in patients with idiopathic liver disease.
We studied 67 HBsAg-negative Israeli patients (36 negative for all HBV serological markers as group 1 and 31 positive for antibodies to HBs and HBc as group 2) with chronic liver disease and cirrhosis of unknown origin using a rapid, sensitive and specific assay for the detection of low levels of hepatitis B virus in serum. This technique uses a high-affinity monoclonal antibody to HBs against an a domain epitope of HBsAg to capture the virion, followed by hepatitis B virus DNA amplification with the polymerase chain reaction. In addition, 55 subjects without liver disease served as controls: Group 3 (n = 32) was negative for all hepatitis B virus markers; group 4 (n = 23) was positive for antibodies to HBs and HBc. We found 11 individuals in group 1 (31%) and 10 in group 2 (29%) harboring low levels of hepatitis B virus DNA in serum. In contrast, no one in group 3 or group 4 was positive by this technique (p less than 0.0001). Using polymerase chain reaction primers spanning other regions of the hepatitis B virus genome and a method of restriction-fragment analysis of polymerase chain reaction-amplified sequences, we detected significant DNA sequence heterogeneity, suggesting infection with distinct hepatitis B virus strains. DNA extracted from paraffin-embedded liver biopsy specimens of 42 patients from groups 1 and 2 was shown to contain hepatitis B virus DNA by polymerase chain reaction in 11 of 12 patients with circulating virion DNA. More important, 18 additional patients whose sera were negative by HBs-antibody capture/polymerase chain reaction amplification had hepatitis B virus DNA sequences in their livers.(ABSTRACT TRUNCATED AT 250 WORDS)
Liang
T J
TJ
Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115.
Baruch
Y
Y
Ben-Porath
E
E
Enat
R
R
Bassan
L
L
Brown
N V
NV
Rimon
N
N
Blum
H E
HE
Wands
J R
JR
D002908:Chronic Disease; D004279:DNA, Viral / Q000378:metabolism; D005814:Genes, Viral; D014644:Genetic Variation; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000378:metabolism; D008107:Liver Diseases / Q000150:complications*; D016133:Polymerase Chain Reaction; D015995:Prevalence
D004279:DNA, Viral