Abstract

The precipitating "e-antigen" was found to be closely associated with hepatitis-B antigen (HBAg) in serum specimens from patients with biopsy-confirmed acute hepatitis, chronic hepatitis, or cirrhosis. The e-antigen was never demonstrated in HBAg-negative sera. Among patients with HB-antigenæmia the e-antigen was significantly more common in those with chronic hepatitis (58% positive) and cirrhosis (31% positive) compared with those with acute hepatitis (10% positive). The e-antigen was a valuable prognostic marker in HBAg-positive acute viral hepatitis, since progression to chronic hepatitis or cirrhosis was confirmed by serial biopsy in 11 out of 19 consecutive e-positive patients. The acute disease in the e-positive patients with acute hepatitis differed significantly from that of the e-negative (HBAg-positive) patients, and was characterised by lower serum-bilirubin concentration and lower serum-aspartate-transaminase activity. The liver morphology showed a more frequent destruction of the limiting plate and a more severe Kupffer cell proliferation.

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