Cell-mediated immune reactivity to hepatitis B surface antigen in liver diseases.

The cellular immune reactivity to hepatitis B surface antigen (HBsAg) was studied in patients with liver diseases using a purified preparation of HBsAg and the leukocyte-migration agarose test. Inhibition of leukocyte migration by HBsAg was found in all 9 patients in the acute phase of viral hepatitis but not during convalescence. HBsAg inhibited migration of leukocytes in only 1 of 15 patients with chronic persistent hepatitis, in none of 16 with chronic periportal hepatitis, and in 2 of 21 with nonhepatic liver diseases. In normal control subjects inhibition of migration was found only in 1 physician exposed to HBsAg. Similar but not identical results were obtained with HBsAg-positive serum used as antigen. In patients with chronic hepatitis there was no correlation between reactivity to HBsAg and the presence of autoantibodies or anti-HBs. While further investigations using other preparations of antigens associated with HBV (e.g., hepatitis B core antigen) may better clarify the role of hepatitis B virus in some liver diseases, the present investigations suggest that a reactivity to HBsAg in patients with acute viral hepatitis may indicate clearing of the antigen, whereas in patients with chronic hepatitis it may reflect a state of specific tolerance to this antigen.