[Clinical and virological evaluation of the detection of pre-S1 and pre-S2 antigens in serum from patients with chronic hepatitis B].
OBJECTIVE
We performed a prospective study to determine the clinical and virological significance of pre-S antigen detection in serum samples from patients with chronic hepatitis B virus infection. Four hundred thirty seven consecutive serum samples from 116 patients were tested for the presence of both pre-S1 and pre-S2 antigens by radioimmunoassay using specific monoclonal antibodies.


RESULTS
The pre-S1 antigen/HBs antigen ratio, gave an estimation of the number of pre-S1 epitopes expressed on the surface of circulating viral particles, and was positively correlated with the intensity of viral replication intensity (P < 0.05). Moreover, the pre-S1 antigen/HBs antigen ratio was significantly higher in patients suffering from chronic hepatitis associated with viral replication (24% +/- 13); in anti-HBe positive patients, the pre-S1 antigen/HBs antigen ratio was higher in patients replicating a HBe antigen minus variant of the hepatitis B virus and suffering from chronic hepatitis (17% +/- 9) than in asymptomatic HBs antigen carriers (5% +/- 6) (P < 0.05). The pre-S2 antigen/HBs antigen ratio was not correlated with the level of viral replication or with the patient's clinical status.


CONCLUSIONS
This study confirms that pre-S1 antigen detection is a reliable marker of hepatitis B virus replication which can be easily performed in chronically infected patients. This assay is especially useful in identifying anti-HBe positive carriers who replicate a minus pre-core mutant and could benefit from antiviral therapy.
Zoulim
F
F
Service d'Hépato-Gastroentérologie, Hôtel-Dieu, Lyon.
Capel
F
F
Berthillon
P
P
Trépo
C
C
Petit
M A
MA
D004279:DNA, Viral / Q000032:analysis*; D004259:DNA-Directed DNA Polymerase / Q000378:metabolism*; D006509:Hepatitis B / Q000097:blood* / Q000201:enzymology / Q000628:therapy / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000201:enzymology / Q000302:isolation & purification / Q000502:physiology*; D006521:Hepatitis, Chronic / Q000097:blood* / Q000201:enzymology / Q000628:therapy / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D011446:Prospective Studies; D011863:Radioimmunoassay; D014779:Virus Replication
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha; D004259:DNA-Directed DNA Polymerase
Evaluation clinique et virologique de la détection des antigènes pré-S1 et pré-S2 dans le sérum des malades atteints d'infection chronique par le virus de l'hépatite B.