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The significance of the HBe system in an area highly endemic for hepatitis B virus

Die Bedeutung des HBe-Systems in einem hochgradigen Hepatitis-B-Virus-Endemiegebiet

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A group of 164 consecutive patients with chronic liver disease and 60 healthy HBsAg carriers were investigated in an area highly endemic for hepatitis B virus (HBV). Eighty-two of the 164 patients (50%) were found to be HBsAg-positive and only 39 (24%) had no HBV markers. A statistically significant correlation was found in the HBsAg-positive patients between the HBe system, their age and the time which had elapsed since their acute episode. Thus, the prevalence of HBeAg decreased with increasing age and with increasing time since their acute episodes. Furthermore, a statistically significant correlation was found between the presence of HBeAg and active chronic liver disease. Of the patients with chronic active hepatitis with or without cirrhosis, all patients below the age of 13 years were HBsAg-positive and 72% were also HBeAg-positive. The data suggest that the HBeAg-positivity in HBsAg carriers is of limited duration and that the seroconversion from HBeAg to anti-HBe is related to a histologically less active or inactive stage of the disease.


In einem hochgradigen Endemiegebiet für das Hepatitis-B-Virus (HBV) wurden 164 nacheinander eingewiesene Patienten mit chronischer Lebererkrankung und 60 gesunde HBsAg-Träger untersucht. 82 der 164 Patienten (50%) waren HBsAg-positiv und nur 39 (24%) hatten keine HBV-Marker. Bei HBsAg-positiven Patienten wurde eine statistisch signifikante Korrelation zwischen dem HBe-System, dem Alter der Patienten und dem zeitlichen Abstand zur akuten Erkrankung festgestellt. Entsprechend war die Prävalenz von HBeAg um so geringer, je länger die akute Erkrankung zurücklag. Zwischen dem Vorhandensein von HBeAg und chronisch aktiver Lebererkrankung fand sich ebenfalls eine statistisch signifikante Korrelation. Alle Patienten mit chronisch aktiver Hepatitis mit oder ohne Zirrhose, die jünger als 13 Jahre waren, waren HBsAg-positiv, 72% von ihnen auch HBeAg-positiv. Daraus läßt sich schließen, daß HBeAg-Positivität bei HBsAg-Trägern von begrenzter Dauer ist, und daß die Serokonversion von HBeAg zu anti-HBe mit einem Stadium geringer histologischer Aktivitätszeichen oder mit einem inaktiven Krankheitsstadium korreliert.

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  1. 1.

    Bianchi, P., Bianchi Porro, C., Coltorti, M., Dardononi, L., Del Vecchio-Blanco, C., Fagiolo, U., Farini, R., Menozzi, I., Naccarto, R., Pagliaro, L., Spano, C., Verme, G. Occurrence of australia antigen in chronic hepatitis in Italy. Gastroenterology 63 (1972) 482–485.

  2. 2.

    Del Vecchio-Blanco, C., Carrella, M., Coltorti, M. Incidence of hepatitis associated antigen in chronic liver disease in southern Italy. Acta Hepato-Gastroenterol. 20 (1973) 138–142.

  3. 3.

    Feinman, S. V., Berris, B., Sinclair, J. C., Wrobel, D. M., Murphy, B. L., Maynard, J. E. e antigen and anti-e in HBsAg carriers. Lancet II (1975) 1173–1175.

  4. 4.

    El Sheikh, N., Woolf, I., Galbraith, R. M., Eddleston, A. L. W. F., Dymock, I. W., Williams, R. e antigen-antibody system as indicator of liver damage in patients with hepatitis B antigen. Br. Med. J. 4 (1975) 252–253.

  5. 5.

    Eleftheriou, N., Thomas, H. C., Heathcote, J., Sherlock, S. Incidence and clinical significance of e antigen and antibody in acute and chronic liver disease. Lancet II (1975) 1171–1173.

  6. 6.

    Aldershvile, J., Skinhøj, P., Frösner, G. G., Hardt, F., Black, F., Deinhardt, F., Nielsen, J. O. The expression pattern of hepatitis B e antigen and antibody in different ethnic and clinical groups of HBsAg carriers. J. Infect. Dis. 142 (1980) 18–22.

  7. 7.

    Realdi, G., Alberti, A., Rugge, M., Bartolotti, F., Rigoli, A. M., Tremolada, F., Rual, A. Seroconversion from hepatitis B e antigen to anti-HBe in chronic hepatitis B virus infection. Gastroenterology 79 (1980) 195–199.

  8. 8.

    De Groote, J., Desmet, J., Gedigk, P., Korb, G., Popper, H., Poulsen, H., Scheuer, P. J., Schmid, M., Thaler, H., Uehlinger, E., Wepler, W. A classification of chronic hepatitis. Review by an international group. Lancet II (1968) 626–628.

  9. 9.

    Review by an international group: Acute and chronic hepatitis revisited. Lancet II (1977) 914–919.

  10. 10.

    Aldershvile, J., Frösner, G. G., Nielsen, J. O., Hardt, F., Deinhardt, F., Skinhøj, P. Hepatitis B e antigen and antibody measured by radioimmunoassay in acute HBsAg-positive hepatitis. J. Infect. Dis. 141 (1980) 293–298.

  11. 11.

    Aldershvile, J., Caspani, B., Frösner, G. G. Hepatitis B e antibody determination: Comparison and evaluation of four different methods. J. Clin. Microbiol. 11 (1980) 458–461.

  12. 12.

    Skinhøj, P., Olesen, H., Cohn, J., Mikkelsen, M. Hepatitis associated antigen in pregnant women. Acta Pathol. Microbiol. Scand. (B) 80 (1972) 362–366.

  13. 13.

    Del Vecchio-Blanco, C., Stroffolini, T., Caporaso, N., Albanese, R. Diffusione di HBsAg ed HBsAb nella popolazione campana. Igiene Moderna 69 (1976) 461–464.

  14. 14.

    Nielsen, J. O., Dietrichsen, O., Juhl, E. Incidence and meaning of the “e” determinant among hepatitis B-antigen positive patients with acute and chronic liver diseases. Lancet II (1974) 913–915.

  15. 15.

    Del Vecchio-Blanco, C., Caporaso, N., Mele, A., Ambrogio, G., Stroffolini, T., Pignalosa, G., Manzillo, G., Maio, G., Ortolani, G., Coltorti, M.: Evolutive pattern of acute viral hepatitis in children and adult subjects. XIVth meeting of the European Association for the Study of the Liver, Düsseldorf 1979, abstracts p. 37.

  16. 16.

    Aldershvile, J., Nielsen, J. O., Dietrichson, O., Hardt, F., Juhl, E., Tage-Jensen, U. Long-term follow-up of e-antigen (HBeAg)-positive acute viral hepatitis. Scand. J. Gastroenterol. 14 (1979) 845–848.

  17. 17.

    Coltorti, M., Del Vecchio-Blanco, C., Caporaso, N., Ambrogio, G., Russo Krauss, P., Mattera, D.: Aspetti e problemi clinici delle epatiti croniche nel nostro Paese. Convegno: Epatiti virali e meningoencefaliti, Napoli, 1978, Atti: Epatiti virali, 5–19, Pacini publications.

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Correspondence to Nicola Caporaso M. D..

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Del Vecchio-Blanco, C., Caporaso, N., Balzano, A. et al. The significance of the HBe system in an area highly endemic for hepatitis B virus. Infection 11, 13–16 (1983).

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  • Chronic Liver Disease
  • Chronic Active Hepatitis
  • Acute Episode
  • HBsAg Carrier
  • Active Chronic Liver Disease