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Evidence for hepatitis B and other virus infection in HBsAg-negative chronic active hepatitis

E Villa, P Jenkins, B Portmann

    Digestive Diseases and Sciences
    |May 1, 1980
    PubMed

    Insights

    Antibody to hepatitis B core antigen (anti-HBc) can indicate ongoing hepatitis B virus infection in patients with HBsAg-negative chronic active hepatitis. Some cases may involve persistent non-A, non-B virus infection.

    Area of Science:

    • Hepatology
    • Virology
    • Immunology

    Background:

    • Chronic active hepatitis can occur without detectable hepatitis B surface antigen (HBsAg).
    • The role of antibody to hepatitis B core antigen (anti-HBc) in diagnosing ongoing infection in these cases is unclear.

    Purpose of the Study:

    • To investigate the significance of anti-HBc in HBsAg-negative chronic active hepatitis.
    • To explore the presence of hepatitis B virus (HBV) antigens in liver tissue and their correlation with anti-HBc titers.

    Main Methods:

    • Detection of anti-HBc in patient sera using serological assays.
    • Immunofluorescence staining of liver biopsy samples for hepatitis B core antigen and HBsAg.
    • Detection of a nuclear antigen unrelated to HBV in anti-HBc-negative cases.

    Main Results:

    • Anti-HBc was detected in 19% of HBsAg-negative chronic active hepatitis patients.
    • Core antigen and/or HBsAg were found in liver cells of some anti-HBc-positive patients, suggesting active HBV infection.
    • Anti-HBc titers decreased over time in patients without liver viral antigens.
    • Viral antigens were cleared in some patients, with one case showing HBV replication reactivation.
    • A non-HBV nuclear antigen was detected in anti-HBc-negative cases, possibly indicating non-A, non-B hepatitis.

    Conclusions:

    • Anti-HBc is a valuable marker for detecting occult hepatitis B virus infection in HBsAg-negative chronic active hepatitis.
    • Persistent HBV infection can be present even without HBsAg.
    • Non-A, non-B hepatitis may be responsible for liver disease in some anti-HBc-negative patients.

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