Early and frequent detection of HBxAg and/or anti-HBx in hepatitis B virus infection.
To clarify the significance of the X gene of hepatitis B virus, we have tested for anti-HBx in the serum and HBxAg in the liver at different stages of the natural history of hepatitis B virus infection. Sera were screened by enzyme-linked immunosorbent assay and positive results confirmed by immunoblot. Purified recombinant MS2 Pol-HBx fusion protein was used as target for both assays. Among serial sera of patients with nonfulminant acute hepatitis, 24 of 64 patients (37.5%) were positive for anti-HBx. In fulminant cases, 15 of 36 patients (42%) had anti-HBx. In chronic hepatitis patients with high rates of hepatitis B virus replication, we found a significantly (p less than 0.01) higher prevalence of anti-HBx, 14 of 25 patients (56%), than in those with low replication, 14 of 66 patients (21%), or among asymptomatic HBsAg carrier blood donors (20 of 126 = 16%) without detectable hepatitis B virus replication (p less than 0.0001). The highest prevalence of anti-HBx was found in HBsAg carriers with cirrhosis (41 of 54 patients = 76%) and/or with hepatocellular carcinoma (18 of 33 patients = 54%). The findings suggest that anti-HBx appears as a common and early marker of hepatitis B virus infection, transient in self-limited hepatitis but persisting with progression to chronicity. In chronic hepatitis, the prevalence of anti-HBx correlated with the intensity and duration of hepatitis B virus replication but neither with the severity of the liver disease nor with malignant transformation per se.(ABSTRACT TRUNCATED AT 250 WORDS)
Vitvitski-Trépo
L
L
Unité de Recherche sur les Hépatites, INSERM U 271, Lyon, France.
Kay
A
A
Pichoud
C
C
Chevallier
P
P
de Dinechin
S
S
Shamoon
B M
BM
Mandart
E
E
Trépo
C
C
Galibert
F
F
D000208:Acute Disease; D015153:Blotting, Western; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006511:Hepatitis B Antigens / Q000032:analysis* / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D006651:Histocytochemistry; D006801:Humans; D007124:Immunoenzyme Techniques; D008099:Liver / Q000276:immunology*; D011237:Predictive Value of Tests; D015534:Trans-Activators / Q000032:analysis* / Q000276:immunology; D054334:Viral Regulatory and Accessory Proteins; D014779:Virus Replication
D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins; C057628:hepatitis B virus X protein