[Successful treatment with alpha-interferon of HBV and HDV coinfection. Case report of a 4-year-old boy]. / Zakazenie HBV i HDV. Opis skutecznego leczenia interferonem alfa u 4-letniego chlopca.

The authors present a case of chronic active hepatitis due to HBV and HDV coinfection. Because of high biochemical and histopathological activity with coexisting hepato- and splenomegaly, treatment with alpha interferon was initiated. HBe/anti-HBe seroconversion and normalisation of biochemical and patomorphological paramethers were achieved.

The value of quantitative measurement of HBeAg and HBsAg before interferon-alpha treatment of chronic hepatitis B in children.

Serum concentrations of HBsAg, HBeAg and hepatitis B virus DNA were measured quantitatively before interferon treatment in 23 children (17 boys, 6 girls) suffering from chronic hepatitis B, and correlated to the outcome of the treatment. Five children remained HBsAg- and HBeAg-positive throughout the treatment and 6 months after the end of the treatment (non-responders), 12 children eliminated HBeAg but not HBsAg (partial responders) and six eliminated HBeAg and HBsAg (complete responders). The five non-responders had significantly higher initial HBsAg and HBeAg concentrations and significantly lower alanine aminotransferase levels than the partial or complete responders. The six complete responders had significantly lower HBsAg concentrations than the partial or non-responders, and seemed to be younger. No significant difference in HBV DNA levels was found in the three response groups. These data suggest that quantitative assays of HBsAg and HBeAg are particularly useful in selecting patients with chronic hepatitis B for interferon therapy.

Analysis of viral proteins in circulating immune complexes from chronic carriers of hepatitis B virus.

Sera from 54 children (mean age 5.8 years) with chronic hepatitis B virus (HBV) infection were investigated for the presence of immune complexes containing HBV proteins. Clinical diagnosis was established by histology and biochemical markers and included chronic persistent (36 cases) or chronic aggressive (seven) hepatitis, liver cirrhosis (six) and HBV-mediated membranous glomerulonephritis (five). Circulating immune complexes were precipitated with 2.5% polyethylene glycol and analysed by immune blot using monoclonal antibodies against S, pre-S2 glycopeptide, pre-S1 and HBe/c epitopes. All sera, including those from 11 healthy HBV-negative blood donors contained PEG-precipitable substances, but the amount of precipitate did not correlate with the presence or amount of HBV proteins. The great majority (36 out of 40) of HBeAg-positive patients contained HBs proteins in immune complexes, but no detectable HBe protein. The immune complexes usually contained more pre-S1 than the free HBsAg particles from the same patient. The precipitates of anti-HBe-positive patients rarely contained HBV proteins (two out of 14) and, if so, in low amounts. During follow up of six patients we found that high levels of HBs-containing immune complexes may be correlated with subsequent elimination of HBV. This elimination is possibly initiated by binding of anti-pre-S1 antibodies to HBV and HBs particles.

Activity of B-cell lineage system in the cord blood of newborns.

To evaluate the B cell lineage system in newborns we estimated IL-4 (BCGF/BSF-1) production by lymphocytes isolated from the cord blood and its influence on antibody synthesis. Undertaken experiments were performed in two groups of newborns: stressed newborns mainly with perinatal infection and full-term healthy neonates, comparing to peripheral blood of adults as control. Results revealed 1) the significantly higher percentage of mature B cells (B1) in cord blood of stressed newborns, 2) the significantly higher IL-4 production comparing to full-term neonates, 3) diminished IgG and IgA synthesis in vitro by allogenic activated B cell blasts in the presence of supernatants from cultures of PHA-stimulated lymphocytes isolated from cord blood of stressed newborns. Induction of IgM synthesis by these active supernatants was significantly higher in stressed newborns than in the other examined groups. We suggest that immunoregulatory mechanisms, which control the production of IL-6 (BCDF/BSF-2) are still not completely mature at birth.