HBe-Antigen in the course and prognosis of hepatitis B infection: a prospective study

The prognostic significance of the HBe-antigen (HBeAg) in the course and outcome of type B hepatitis was studied prospectively in 71 susceptible oncology patients. The patients had been exposed to tumor cell vaccines inadvertently contaminated with hepatitis B surface antigen (HBsAg)-containing plasma. Forty-five patients (63%) were infected. These 45 showed three types of acute seroresponse: HBsAg and HBeAg, 28 patients (62%); HBsAg alone, 8 patients (18%); and a primary antibody to HBsAg (anti-HBs) response, 9 patients (20%). There was no significant difference in acute course and outcome between the two HBs-antigenemic groups. All primary anti-HBs responders had asymptomatic infections. Seventeen patients receiving chemotherapy during the period of hepatitis B exposure were significantly more prone to symptomatic infection with acute HBs-antigenemia, and 2 of these patients developed chronic active hepatitis. The HBeAg is common early in acute hepatitis B among solid tumor patients and at this stage in disease has no prognostic significance independent of HBsAg.