surface antigen hepatitis antibody hepatitis virus b virus disease virus antigen virus antibody

To understand the role of e-antigen and antibody in acute viral hepatitis, 50 HBsAg positive and histologically verified patients were studied and followed-up. Serum specimens were submitted for detection of e-antigen and antibody by the Micro-Ouchterlony immuno-diffusion method. In the 50 patients, 10(20.0%) were e-antigen positive and 5(10.0%) anti-e positive. The serum bilirubin and SGPT on admission were compared in e-positive and e-negative patients. Though the levels of serum bilirubin and SGPT in e-antigen positive patients were lower than those of e-negative patients, the difference was not significant statistically (P>0.5). The timing of the test is important to the positive rate of e-antigen and anti-e as 40% of acute hepatitis cases studied within 2 weeks after onset had e- antigen but none had anti-e, while the rate of e-antigen decreased and the rate of anti-e increased after 2 weeks. Clinical follow-up study showed that 71.4% of e-antigen positive patients had persistenly abnormal SGPT for more than 6 months, while only 20.8% of e-antigen negative patients persisted that long (P=0.012). But the outcome was not different in anti-e positive and negative patients. Histological follow-up in 3 of the 10 cases of e-antigen positive acute hepatitis showed pictures of chronic active hepatitis (CAH). Only 2 of 12 follow-up biopsies in 78 cases of e-antigen negative acute hepatitis had pictures of CAH. The difference of histological outcome in e-antigen positive and negative patients is also statistically significant (P<0.01). It is concluded that the detection of e-antigen by immunodiffusion in acute viral hepatitis patients on admission has prognostic value.