Galán M I, Tomás J, Bernal M C, Salmerón F J, Maroto M C
Microbiology Service, University Hospital of Granada, Spain.
J Clin Pathol. 1991 Jan;44(1):25-8. doi: 10.1136/jcp.44.1.25.
The diagnostic and prognostic value of pre-S(1)Ag and pre-S(2)Ab was investigated in 69 HBsAg surface antigen positive patients--14 with acute hepatitis B, 30 with chronic liver disease (six chronic persistent hepatitis, 14 chronic active hepatitis, 10 with cirrhosis) and in 25 asymptomatic carriers. Pre-S(1)Ag was found in all patients with chronic hepatitis B virus (HBV) infection regardless of viral replication. In contrast, pre-S(2)Ab was not detected in any patients. Acute hepatitis was studied sequentially with periodic controls at 20 day intervals. Pre-S(1)Ag cleared before HBsAg in six of 14 (43%) patients who progressed favourably, and the two antigens cleared simultaneously in eight of 14 (57%) cases. Patients with early clearance of pre-S(1)Ag progressed favourably, thus indicating the prognostic value of this test, which, however, is still of limited practical application given the small temporal difference between the moment of clearance of the two antigens. The first markers to clear, however, were HBeAg and DNA-HBV, which showed significant differences with respect to the clearance of HBsAg. Moreover, pre-S(2)Ab appeared before HBsAb in 57.1% of our patients and was found in some patients before pre-S(1)Ag and HBsAg had cleared (42.8%), thus allowing complete viral clearance and acute HBV infection to be predicted earlier.
对69例乙肝表面抗原（HBsAg）阳性患者进行了前S(1)抗原（pre-S(1)Ag）和前S(2)抗体（pre-S(2)Ab）的诊断和预后价值研究，其中14例为急性乙型肝炎患者，30例为慢性肝病患者（6例慢性持续性肝炎、14例慢性活动性肝炎、10例肝硬化），25例为无症状携带者。在所有慢性乙型肝炎病毒（HBV）感染患者中均检测到pre-S(1)Ag，无论病毒复制情况如何。相比之下，所有患者均未检测到pre-S(2)Ab。对急性肝炎患者每隔20天进行定期检查以进行连续研究。在14例预后良好的患者中，有6例（43%）的pre-S(1)Ag在HBsAg之前清除，14例中有8例（57%）的两种抗原同时清除。pre-S(1)Ag早期清除的患者预后良好，这表明该检测具有预后价值，然而，鉴于两种抗原清除时间的差异较小，其实际应用仍然有限。然而，首先清除的标志物是HBeAg和乙肝病毒DNA（DNA-HBV），它们在清除HBsAg方面存在显著差异。此外，在我们的患者中，57.1%的pre-S(2)Ab出现在HBsAb之前，在一些患者中，pre-S(2)Ab在pre-S(1)Ag和HBsAg清除之前就已出现（42.8%），从而能够更早地预测病毒的完全清除和急性HBV感染。
