Hepatitis B surface antigen/IgM complexes: relation to receptors for polymerized human serum albumin, hepatitis B virus (HBV) DNA polymerase activity and HBV markers.

The presence and the level of hepatitis B surface antigen (HBsAg)/IgM complexes were determined in 54 chronic HBsAg carriers in relation to receptors for polymerized human serum albumin (pHSA-R) tested by specific radioimmunoassay, and to hepatitis B virus-DNA polymerase (HBV-DNAp). HBsAg/IgM complexes, correlated significantly with the HBsAg concentration but, at a similar HBsAg concentration, significant highest values of HBsAg/IgM complexes were found among HBeAg positive patients. In addition, a significant correlation was found between HBsAg/IgM complex levels, HBeAg titres and HBV-DNAp activity (r = 0.628, p less than 0.001 and r = 0.559, p less than 0.001, respectively). Moreover, a positive linear correlation was found when comparing HBsAg/IgM complexes and pHSA-R levels (r = 0.848, p less than 0.001). Patients who were positive for HBsAg/IgM complexes had a significantly higher glutamate-pyruvate transaminase (GPT) level than those who did not show any complexes. In conclusion, HBsAg/IgM complexes seemed to be indirectly related to HBV replication.

[Hepatic complications in the postoperative of cardiac surgery]. / Complicaciones hepáticas en el postoperatorio de la cirugía cardíaca.

In a study of fifty patients subjected to cardiac surgery nine (18%) had immediate post-operative liver complications. These included persistente jaundice, an increase in hepatomegaly and elevation of the alkaline phosphatase. In these and the rest of the cases there were extra-hepatic complications such as hyposystole, infarct, the post-pericardiotomy syndrome as related to the heart. Pulmonary complications were of infectious nature and a general complication was sepsis. These complications were sufficiently important to relate them etiologically to the hepatic disorder. Especially important is right hyposystole and it or tricuspid insufficiency can be blamed for the hepatic disorder in some of these patient. Nonetheless, these hepatic complications are seen less frequently now that we are giving effective treatment to the tricuspid insufficiency during the surgical intervention. We observed the clinical picture known as "benign postoperative cholestasis" in only two patients. Hepatitis with jaundice was seen in four patients during one to three months postoperatively. This was HB hepatitis and its course was more prolonged than that usually seen in Mexico, and it turned into chronic hepatitis in four patients. Biopsies done in one case a six months and in the other at nine months post-operatively showed the picture of chronic aggresive hepatitis. In those patients who did not have hepatic complications a late liver evaluation showed an improvement as compared to the pre-operative condition which was parallel to the hemodynamic improvement.