Abstract

Sera and biopsied liver specimens from 45 hepatitis B surface antigen (HBsAg) carriers both with or without overt liver diseases and negative for anti-delta antibody, were examined for markers of hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg), hepatitis B virus deoxyribonucleic acid (HBV-DNA) in serum and hepatitis B core antigen (HBcAg) in liver. HBV-DNA in serum was assayed by the spot hybridization technique, and HBcAg in the liver was investigated by the peroxidase anti-peroxidase method. Among the parameters showing active replication of HBV, serum HBeAg, serum HBV-DNA and intrahepatic HBcAg were found in 27 (60%), 27 (60%) and in 22 (48.9%) of 45 HBsAg carriers, respectively. The presence of serum HBV-DNA and of intrahepatic HBcAg in HBeAg positive cases and the absence of serum HBV-DNA and of intrahepatic HBcAg in anti-HBe positive cases was the rule with few disparate cases among those with chronic liver disease. These parameters were not useful in predicting the histology on liver biopsy. The activity of hepatic inflammation in the HBsAg chronic carriers assessed by serum alanine aminotransferase level closely paralleled HBV-DNA in serum but not HBeAg in serum, HBcAg in liver or histologic picture on biopsy. HBV-DNA may be the most sensitive parameter of replication of hepatitis B virus and of the activity of inflammation in the liver.

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