Profiles of acute-phase reactants and clinical significance of alpha 2-macroglobulin in acute hepatitis B.

Acute-phase proteins (APRs), albumin, and alpha 2-macroglobulin (alpha 2M), were studied in 14 patients with acute hepatitis B. No acute-phase reaction in this disease was observed, contrary to other viral infections. Peak SGPT correlated negatively with prealbumin, but no other relations with APR, albumin, or alpha 2M were found. As many APRs have antiinflammatory properties, the relation of these proteins at the start and the subsequent course of hepatitis, measured by "SGPT area" and duration of the illness, was calculated. The serum level of APR and albumin at the start of the disease is not significantly related to the subsequent course. However alpha 2M, not being an APR, and prealbumin are negatively correlated to these parameters: high levels of alpha 2M and prealbumin point to a less severe course than low levels. The clinical significance of the depressed acute-phase reaction during hepatitis and the effect of alpha 2M are discussed.