Endogenous serum interferon-alpha in patients with chronic hepatitis B virus infection.

Serum endogenous interferon-alpha was determined in 42 patients with chronic hepatitis B virus infection by radioimmunoassay using an Abbott kit (USA). The study sample included 26 males and 16 females, aged 3 to 59 years (mean, 30.1). Ten of these patients had a history of acute viral hepatitis B carrying HBsAg for more than 6 months. Thirty two patients were accidentally found to be virus carriers for 8 months to 15 years. Six of these were treated with interferon-alpha and one with Ursofalk. Forty one patients (97.62% +/- 2.38) were anti-HBcIgG positive which confirmed former hepatitis B virus infection. Only one patient who was anti-HBcIgG positive was found to be also anti-HBcIgG positive, anti-HBcIgM positive, HBeAg negative, and anti-HBe positive later biophysically verified as exacerbated chronic active hepatitis. Serum HBeAg was detected in 13 of the whole sample (30.95% +/- 7.13); 8 patients (32% +/- 9.33) were HBV-DNA positive, i.e., a third of the cases presented with active replication of the hepatitis B virus. In all 42 patients with chronic hepatitis B virus infection (convalescence and health HBsAg carriers) serum interferon-alpha levels were nil or close to nil. Only in the patient with chronic active hepatitis the serum interferon level was 3.83 IU/ml. These data support the observations that interferon-alpha production is reduced in chronic hepatitis B virus infection and are consistent with the view that treatment with exogenous interferon-alpha stimulates the clearance of the virus.

Clinical significance of serum HBeAg and HBV-DNA-specific values of virus replication in chronic hepatitis-B virus infection.

The prevalence of serum HBV-DNA and that of HBeAg was evaluated in 44 subjects (27 males and 17 females) aged between 3 and 59 years. They were divided in two groups: (A) chronic asymptomatic HBsAg carriers; and (B) chronic HBsAg carriers with a history of HBV infection. The patients had been chronic HBV carriers between 8 months and 15 years. All underwent clinical and biochemical evaluation. The serological markers of HBV infection were tested using ABBOTT assay kits. The serum HBV-DNA was quantified using a hemiluminiscence molecular hybridization assay (Digene-Murex). HBV-DNA+ were 13 patients (29.55 +/- 6.88%). The highest level of viral replication (up to 50%) was measured in the patients aged from 3 to 29 years while in the others a 3 to 4-fold decrease of the viral replication was detected. HBV-DNA+ were 8 (23.53 +/- 6.39%) of the chronic asymptomatic hepatitis B carriers and 5 (50.00 +/- 7.5%) of the chronic HBV carriers with former acute hepatitis B infection. Similar results were obtained for the other index of viral replication--HBeAg/anti-HBe. Eight (23.53 +/- 6.39%) patients from group I and 4 (40.00 +/- 7.38%) patients from group II were HBeAg+ while anti-HBe+ were 26 (76.47 +/- 6.39%) and 6 (60.00 +/- 7.38%) patients from group I and II, respectively, i.e., about a quarter of the chronic asymptomatic HBsAg carriers and half of the chronic HBV carriers that had had an acute hepatitis B virus infection had HBV replication in their bodies. HBeAg+ patients had high levels of serum HBV-DNA (625.70-3328.00 pg/ml) which indicated extremely intensive viral replication. The presence of HBeAg and especially of HBV-DNA as markers of viral replication in chronic asymptomatic HBsAg carriers and chronic HBsAg carriers with a prior acute hepatitis B virus infection provide important information for the clinical decisions.