The e antigen and antibody in the serum of patients with HBsAg-positive liver disease and in asymptomatic carriers

Abstract

Serum samples from 103 HBsAg positive and 69 negative patients were examined in Ouchterlony double diffusion in agarose for the presence of e antigen and anti-e antibody. e antigen was found in 66% of the cases of active chronic hepatitis, 18% of those of active cirrhosis, and 12% of those of acute hepatitis. Anti-e antibody was found only in asymptomatic chronic carriers; it occurred in 56% of HBsAg-positive individuals with normal livers at biopsy. No e reactivity was found in 6 subjects with inactive disease and in 3 with chronic persistent hepatitis. The e system seems a valuable diagnostic tool utilizing the presence of the antigen to differentiate patients with chronic progressive disease from healthy carriers who, in contrast, often have circulating anti-e antibodies; its clinical value, however, is at present limited by the low sensitivity of the technique used for antigen detection. A significant association between e antigen and the intrahepatic expression of the core determinant of the HB virus was observed inthis study, suggesting they have a similar role in pathogenicity and infectivity; the association between anti-e antibody and HBsAg appeared uncertain, HBsAg being present in the liver irrespective of e reactivity.