Impaired Antibody Synthesis in Patients With Chronic Hepatitis B Infection

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Abstract
In vitro synthesis of the anti–HBc, anti–HBs and polyclonal IgG and IgM classes of antibodies were determined from supernatants of peripheral blood mononuclear cells cultured in the presence of pokeweed mitogen. Thirty–seven patients with chronic hepatitis B and 10 healthy control subjects whose sera were positive for anti–HBs formed the study group. Twenty–four of 37 patients showed histologic evidence of chronic active hepatitis B while the remaining 13 patients had chronic persistent hepatitis B. Lymphocytes from chronic persistent hepatitis B, chronic active hepatitis B and healthy controls secreted similar levels of IgM. However, IgG synthesis was markedly impaired (p < 0.002) in the chronic persistent hepatitis B group as compared with healthy controls or chronic active hepatitis B patients. In vitro anti–HBc production and serum anti–HBc titers correlated directly with hepatocellular inflammation and inversely with serum hepatitis B virus DNA. Anti–HBc synthesis was significantly higher in chronic active hepatitis B patients who exhibited a more pronounced hepatocellular damage when compared to chronic persistent hepatitis B patients who had little or no liver cell injury.

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