Clearance of hepatitis b virus dna and pre‐s surface antigens in patients with markers of acute viral replication

Publisher Website
Google Scholar
Abstract
To clarify the relationship between the pre‐S antigens and other serological markers of hepatitis B virus (HBV) replication, we followed up 27 patients: 21 presented with symptoms of acute hepatitis (two progressed to chronicity) and six suffered from chronic hepatitis. Pre‐S1, pre‐S2, HBV DNA, IgM antihepatitis core antigen (HBc), hepatitis B e antigen(HBeAg), and anti‐HBe were detected in about 200 sera serially collected at different times for at least 6–12 months from the onset of clinical observation. In the early symptomatic phase of acute hepatitis, the pre‐S1and pre‐S2antigens were present in 95% of the cases and correlated well with high levels of alaninetransferase (ALT) and IgM anti‐HBc, while HBV DNA was present in the sera of only six (28.6%) patients (P< 0.0001). This was the first marker to disappear (1 month after the initial stage). All of the HBV DNA‐positive patients were also HBeAg positive, whereas no HBeAg‐negative subjects were found with serum HBV DNA. In the six chronic patients, pre‐S antigens were always present independently of the HBeAg/anti‐HBe status; HBV DNA was detected in three of them, even if transiently, and in two of these it reappeared together with the pre‐S2epitope. The follow‐up data suggest that, in acute hepatitis, the clearance of pre‐S antigens can be considered as a prognostic index of clinical resolution and that, in chronic hepatitis, the persistence of pre‐S antigens seems to indicate progression of the disease. In particular, pre‐S2, in patients in whom it is intermittent, can be considered as an index of reactivation.