Diodati G, Pontisso P, Bonetti P, Stenico D, Noventa F, Alberti A, Realdi G
Department of Clinical Medicine, 2nd Medical Clinic, Padua Medical University, Italy.
Digestion. 1988;39(4):251-6. doi: 10.1159/000199633.
In an attempt to evaluate a possible correlation between cryptogenic chronic liver disease and a present or past hepatitis B virus (HBV) infection, we studied 17 patients with hepatitis B surface antigen (HBsAg)-negative, nonalcoholic chronic liver disease; 9 of them were positive for serum HBsAg detected by a solid-phase enzyme immunoassay with monoclonal antibody (M-EIA) and 8 were negative for the same marker. Liver hepatitis B core antigen (HBcAg), studied by an indirect immunofluorescence technique, was present in 55.5% of the patients positive for serum HBsAg by M-EIA. In the same group of patients, liver HBV-DNA was found in 66.6% of the patients. On the other hand, only 1 patient without serum positivity for HBsAg by M-EIA was positive for liver HBcAg and HBV-DNA. None of our patients showed serum positivity for HBV-DNA sequences. We conclude that HBV infection may be a possible cause of cryptogenic chronic liver disease; this HBV-related, HBsAg-negative chronic liver disease seems to have no viral replication or undetectable levels of HBV-DNA in serum. HBsAg, detected by a monoclonal assay, seems to be a suitable marker to identify this subgroup of patients with HBsAg-negative chronic liver disease.
为了评估隐匿性慢性肝病与现患或既往乙型肝炎病毒（HBV）感染之间可能存在的相关性，我们研究了17例乙型肝炎表面抗原（HBsAg）阴性的非酒精性慢性肝病患者；其中9例通过单克隆抗体固相酶免疫测定法（M-EIA）检测血清HBsAg呈阳性，8例该标志物呈阴性。采用间接免疫荧光技术研究发现，M-EIA检测血清HBsAg呈阳性的患者中，55.5%存在肝组织乙肝核心抗原（HBcAg）。在同一组患者中，66.6%的患者肝组织中检测到HBV-DNA。另一方面，M-EIA检测血清HBsAg无阳性反应的患者中，仅1例肝组织HBcAg和HBV-DNA呈阳性。我们的患者血清中均未检测到HBV-DNA序列阳性。我们得出结论，HBV感染可能是隐匿性慢性肝病的一个可能病因；这种与HBV相关的、HBsAg阴性的慢性肝病似乎无病毒复制，或血清中HBV-DNA水平检测不到。通过单克隆检测法检测到的HBsAg似乎是识别该组HBsAg阴性慢性肝病患者的合适标志物。
