Summary
Forty-two children with HBsAg positive chronic hepatitis who received immunosuppressive therapy underwent multiple liver biopsies over periods ranging from one to five years. The presence of HBsAg, HBcAg, deltaAg, antinuclear antibodies and immune complexes was studied using immunofluorescent techniques. The data were correlated with the clinical status of the patients. The presence of HBsAg, HBcAg and deltaAg remained unchanged throughout the study in most positive patients. All 30 HBcAg positive cases were still positive at the end of the study. One of the negative cases became positive. Eight of the ten delta antigen positive cases showed no change. Intrahepatic immunoglobulins, immune complexes and antinuclear antibodies showed a decrease in positivity in a significant number of patients. Fifteen of the 36 patients positive for intrahepatic immunoglobulins became negative during the study, as did 12 of the 29 immune complex positive subjects and 22 of the 33 antinuclear antibody-positive cases. The persistence of HBV antigens seems to be independent of the clinical course. On the other hand, the persistence of positive immunological indices corresponds to a less favourable outcome.
Zusammenfassung
Bei 42 Kindern mit HBsAg-positiver chronischer Hepatitis, die immunsuppressiv behandelt wurden, wurden über einen Zeitraum von ein bis fünf Jahren mehrfach Leberbiopsien durchgeführt. Mittels Immunfluoreszenztechniken wurde nach HBsAg, deltaAg, antinukleären Antikörpern und Immunkomplexen gesucht. Die Befunde wurden mit dem klinischen Zustand der Patienten in Beziehung gebracht. Bei den meisten Patienten waren während des Untersuchungszeitraumes HBsAg, HBcAg und deltaAg unverändert vorhanden. Am Ende der Studie waren noch alle 30 Patienten mit positivem HBcAg positiv, einer der negativen Fälle wurde positiv. Acht der zehn delta Antigen-positiven Fälle blieben positiv. Positive Befunde für intrahepatische Immunglobuline, Immunkomplexe und antinukleäre Antikörper veränderten sich bei einer beträchtlichen Anzahl von Patienten; so wurden intrahepatische Immunglobuline bei 15 von 36 Patienten, Immunkomplexe bei 12 von 29 Patienten und antinukleäre Antikörper bei 22 von 33 Patienten negativ. Die Persistenz von HBV-Antigenen scheint vom klinischen Verlauf unabhängig zu sein, doch geht die Persistenz positiver immunologischer Parameter mit einem weniger günstigen Verlauf einher.
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Calzia, R., Piscopo, R., Navone, C. et al. A long-term study of hepatitis B virus-related antigens and immunological parameters in children with chronic hepatitis. Infection 12, 194–196 (1984). https://doi.org/10.1007/BF01640898
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DOI: https://doi.org/10.1007/BF01640898