PRES1 ANTIGEN ANTIBODY PATTERNS FOLLOWING INTERFERON THERAPY IN ACUTEAND CHRONIC HEPATITIS-B/

The relation between preS1 antigen/antibody system and different phase s of hepatitis B virus infection were studied in 425 serum samples fro m 50 hepatitis B patients before, during and after antiviral therapy u sing interferon alone or in combination with corticosteroid withdrawal . A typical profile of self-limited acute hepatitis B was characterize d by hepatitis B virus-DNA clearance using polymerase chain reaction a nd preS antigens using monoclonal radioimmunoassays and by antibody re sponses to the middle and the large HBs proteins (gp33/gp36 and p39/gp 42) using immunoblotting quantitative analysis. After interferon thera py in patients with protracted hepatitis B, complete eradication of th e virus was observed in 70% of patients, and antibody response directe d to middle HBs and large HBs proteins could be induced. Conversely, t his antibody response was never detected in follow-up studies of chron ic active hepatitis B patients who responded well to antiviral therapy and lost HBs, preS2 and preS1 antigens. Most interesting, in 50% of p atients with HBeAg-positive chronic active hepatitis B who received co mbination therapy and in 67% of patients with anti-HBe-positive chroni c active hepatitis B given interferon alone, the elevated serum preS1A g/HBsAg ratio persisted after treatment was discontinued and even incr eased until the end of follow-up when hepatitis B virus DNA was undete ctable in serum by the conventional hybridization technique. This rebo und of preS1 antigen expression following antiviral therapy in patient s with chronic active hepatitis B may indicate virus persistence, sugg esting the possibility of relapse through wild-type hepatitis B virus or the emergence of hepatitis B virus mutants. (C) Journal of Hepatolo gy.