Shift from free "small" hepatitis B e antigen to IgG-bound "large" form in the circulation of human beings and a chimpanzee acutely infected with hepatitis B virus.

Hepatitis B e antigen (HBeAg) occurs both free and in association with IgG in the circulation of individuals infected with hepatitis B virus (HBV). We determined free and IgG-bound HBeAg forms separately in the serum of humans and a chimpanzee acutely infected with HBV. In a patient with laboratory acquired HBV infection, the proportion of free HBeAg gradually decreased from 89% to 23%. A similar shift from free to IgG-bound form of HBeAg was invariably observed in 5 additional patients with acute Type B hepatitis. In a chimpanzee that had been experimentally inoculated with HBV, free HBeAg appeared first, then gradually and completely shifted to the IgG-bound form. Finally, IgG-bound HBeAg disappeared, and antibody to HBeAg was detectable in the serum. The determination of both free and IgG-bound forms of HBeAg may provide valuable information, because their ratio reflects the stage and prognosis of acute HBV infection.