Ti. Michalak et al., HEPATITIS-B VIRUS PERSISTENCE AFTER RECOVERY FROM ACUTE VIRAL-HEPATITIS, The Journal of clinical investigation, 93(1), 1994, pp. 230-239
Contrary to current opinion, the disappearance of hepatitis B surface
antigen (HBsAg) from the serum, the development of anti-HBs antibodies
, and normalization of liver function may not reflect complete virolog
ical recovery from acute hepatitis B virus (HBV) infection. By using t
he polymerase chain reaction (PCR), in the current study we demonstrat
e long-term persistence of HBV DNA in the serum and peripheral blood m
ononuclear cells (PBMC) of four patients for up to 70 mo after complet
e clinical, biochemical, and serological recovery from acute viral hep
atitis. Serum HBV DNA reactivity co-sedimented with HBsAg in sucrose g
radients, and it displayed the size and density characteristics of nak
ed core particles and intact HBV virions, presumably contained within
circulating immune complexes in these anti-HBs antibody-positive sera.
HBV DNA was also present in PBMC in late convalescent samples from al
l four patients, and HBV RNA was detected in late convalescent phase P
BMC in two of these patients. These results suggest that HBV DNA, and
possibly HBV virions, can be present in the serum, and that the viral
genome can persist in a transcriptionally active form in PBMC for > 5
yr after complete clinical and serological recovery from acute viral h
epatitis.