[The prognostic significance of quantitative HBsAG determination in acute hepatitis B]

The HBsAg concentrations were measured in serial serum samples of 27 patients with acute hepatitis B and of 22 patients with chronic active hepatitis. 21 of the 27 patients with acute hepatitis exhibited a 50% reduction of the HBsAg concentration within 10-20 days of the first determination. In 19 of these individuals HBsAg became undetectable within 3 months and fell below 10 units/ml in another individual. The HBsAg concentration started to rise again in one patient and remained high later. In 6 of the 27 patients with acute hepatitis, the HBsAg concentration showed no 50% reduction within 10-20 days. HBsAg was still at high levels in 5 of these individuals at the end of the observation period of 6-12 months. The HBsAg concentrations in patients with chronic active hepatitis were comparable to the initial values observed in patients with acute hepatitis and persisted at high levels in all 22 individuals. Thus, measurement of the HBsAg concentration in two consecutive sera taken within 10-20 days makes it possible to predict the outcome of an acute hepatitis B-virus infection. When comparing patients in the initial phase of acute hepatitis B or chronic hepatitis patients with asymptomatic chronic HBsAg carriers on hemodialysis or with blood donors, the mean HBsAg concentrations were highest in hemodialysis patients and lowest in HBsAg positive blood donors.