Clearance of hepatitis B e-antigen in chronic hepatitis B infection.
HBeAg and anti-HBe were determined by radioimmunoassay (Abbott HBe) in serial serum samples from 22 patients who had been HBsAg-positive for more than 1 year. Seventeen patients (77%) were HBeAg-positive at onset of illness. Eight of these patients were persistently HBeAg-positive during 2.5-8.5 years' follow-up study (mean, 5.4 years). Chronic persistent hepatitis (CPH) developed in one of these patients and chronic active hepatitis (CAH) in seven patients. Nine persistently HBsAg-positive patients were transiently HBeAg-positive. Seven of these patients developed CPH, and they all lost HBeAg within 2 years of onset of illness. One patient, who was HBeAg-positive for 4 years, developed CAH with cirrhosis after loss of HBeAg. In five patients, HBeAg could not be detected. They were anti-HBe-positive at onset of illness; four developed CAH and/or cirrhosis, and one developed CPH. Progression from CPH or nonspecific reactive hepatitis to CAH was observed in two persistently HBeAg-positive patients. Prolonged detection of HBeAg in CPH is a reason for repeated liver biopsy to reevaluate the diagnosis. The behaviour of the e-antigen system in CAH seems to be more complex than in CPH, perhaps indicating a different pathogenetic mechanism of chronicity in CAH.
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000032:analysis; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000201:enzymology / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006511:Hepatitis B Antigens / Q000032:analysis*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011863:Radioimmunoassay
D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D000410:Alanine Transaminase