Characteristics of the early phase of chronicity in acute hepatitis B infection

Citation
Ra. Heijtink et al., Characteristics of the early phase of chronicity in acute hepatitis B infection, J MED VIROL, 57(4), 1999, pp. 331-336
Citations number
14
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Microbiology
Journal title
JOURNAL OF MEDICAL VIROLOGY
ISSN journal
01466615 → ACNP
Volume
57
Issue
4
Year of publication
1999
Pages
331 - 336
Database
ISI
SICI code
0146-6615(199904)57:4<331:COTEPO>2.0.ZU;2-B
Abstract
The mechanism of development of chronicity after acute hepatitis B infectio n has not been elucidated fully. Following a single source outbreak of hepa titis B among 79 adult women, three patients (4%) became chronic carriers o f hepatitis B virus (HBV). We compared features of the virus and antibody r esponse of the latter three patients with those of 12 HBeAg-positive cases with resolving infection. The virus genotype was D, antigenic subtype ayw(2 ). Base sequence analysis of S- and C-gene regions revealed no differences between the two groups. During the acute illness the three patients who dev eloped chronicity had a remarkable transient reduction of HBsAg, HBeAg, and HBV DNA levels at 14-20 weeks after infection, the time of HBeAg seroconve rsion in the patients who cleared the infection. One HBeAg-specific monoclo nal antibody (HBOT.95A) used as solid-phase antibody in a sandwich enzyme i mmunoassay detected an increased HBeAg signal in 2 of the 3 patients that d eveloped chronicity and in 1 of the 12 patients who recovered. The latter p atient had an exceptional long period of HBsAg antigenemia. Standard HBeAg assays detected HBeAg in all cases. HBeAg and anti-HBe-positive serum sampl es from the patients who recovered could inhibit the HBOT.95A response. The results suggest that chronic hepatitis B develops after an interruption of immune clearance. Differentiation of the antibody response to HBeAg may he lp to find patients with an increased risk for this interrupted immune clea rance who might be candidates for an early intervention therapy. (C) 1999 W iley-Liss, Inc.