Möller B, Hopf U, Pöschke S, Alexander M, Friedrich-Jähnicke B, Mostertz P, L'age M
Medizinische Klinik des Universitätsklinikums, Charlottenburg, Frele Universität Berlin, Federal Republic of Germany.
Liver. 1987 Oct;7(5):298-305. doi: 10.1111/j.1600-0676.1987.tb00359.x.
Treatment of serum precipitates with sodium thiocyanate in patients with hepatitis B virus (HBV) replication results in liberation of circulating hepatitis core antigen (HBcAg) which can be demonstrated radioimmunologically. Follow-up investigations were performed in 80 patients with acute hepatitis B. Sera were examined for HBcAg. HBV DNA and conventional HBV markers. At the time of admission to hospital 34 of 80 (42%) patients were HBeAg positive. Twenty-six (76%) of the 34 HBcAg positive patients were HBV DNA positive, and circulating HBcAg was detectable in 25 of 34 (73%) HBcAg positive cases. In patients with uncomplicated courses of acute hepatitis B the serological HBcAg assay and HBV DNA became negative 1 to 8 weeks before elimination of HBeAg and up to 12 weeks earlier than the sera became negative for HBsAg. Five patients (6%) showed transition to chronic hepatitis B with persistence of HBsAg, HBeAg, HBV DNA and HBcAg in serum. One patient with acute hepatitis B and development of chronic hepatitis suffered from acquired immunodeficiency syndrome and showed delayed formation of anti-HBc. In this case uncomplexed HBcAg was demonstrable during the acute phase of hepatitis B. With the appearance of anti-HBc HBcAg circulated in a complexed form. The data indicate that serological determinations of HBcAg and HBV DNA can serve as prognostic markers in the early phase of acute hepatitis B. The demonstration of uncomplexed HBcAg in serum of a patient with inadequate formation of anti-HBc supports the hypothesis that circulating HBcAg is usually complexed by specific antibodies.
在乙型肝炎病毒（HBV）复制的患者中，用硫氰酸钠处理血清沉淀物会导致循环中乙型肝炎核心抗原（HBcAg）的释放，这可以通过放射免疫法检测到。对80例急性乙型肝炎患者进行了随访调查。检测血清中的HBcAg、HBV DNA和传统的HBV标志物。入院时，80例患者中有34例（42%）HBeAg阳性。34例HBcAg阳性患者中有26例（76%）HBV DNA阳性，34例HBcAg阳性病例中有25例（73%）可检测到循环中的HBcAg。在急性乙型肝炎病情未复杂的患者中，血清学HBcAg检测和HBV DNA在HBeAg消失前1至8周变为阴性，比血清HBsAg变为阴性早12周。5例患者（6%）转变为慢性乙型肝炎，血清中持续存在HBsAg、HBeAg、HBV DNA和HBcAg。1例急性乙型肝炎并发展为慢性肝炎的患者患有获得性免疫缺陷综合征，抗-HBc形成延迟。在这种情况下，在乙型肝炎急性期可检测到未结合的HBcAg。随着抗-HBc的出现，HBcAg以结合形式循环。数据表明，HBcAg和HBV DNA的血清学检测可作为急性乙型肝炎早期的预后标志物。在抗-HBc形成不足的患者血清中检测到未结合的HBcAg，支持了循环中的HBcAg通常被特异性抗体结合的假说。
