HBsAg immune complexes in the course of infection with hepatitis B virus.

Serial serum samples from 113 patients with different forms of HBV-related liver disease and HBsAg carriership were tested for the presence of HBsAg, anti-HBc, anti-HBs, and HBsAg-anti-HBs immune complexes (IC). Eight patients with acute type B hepatitis had the irmultiple serum samples tested in an average period of time from 68 days before the appearance of clinical symptoms up to 277 days after the onset of clinical symptoms. In the remaining cases serum samples were obtained during the period after the appearance of clinical symptoms. The highest frequency of immune complexes of HBsAg was observed in acute hepatitis (twenty-eight out of thirty examined cases—93·3%). The patients showing high level of anti-HBs response eliminated HBsAg from the circulation earlier than the patients showing low level of anti-HBs response. In chronic aggressive hepatitis the frequency of HBsAg complexes was higher (ten out of twenty-five cases—40%) than in chronic persistent hepatitis (two out of nine cases—22%); HBsAg complexes were found in four out of twenty-two symptomless carriers of HBsAg (18%). The obtained results are in agreement with the hypothesis that an optimal humoral immune response at the acute stage of hepatitis type B results in rapid elimination of HBV antigens. Conversely, an inadequate response at this stage favours replication of the virus in hepatocytes, prolongation of HBs antigenaemia, and the appearance of chronic forms of hepatitis.