HEPATITIS-B VIRUS PERSISTENCE AFTER RECOVERY FROM ACUTE VIRAL-HEPATITIS

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.