Endo Y, Gudat F, Bianchi L, Mihatsch M, Gasser M, Stalder G A, Schmid M
Schweiz Med Wochenschr. 1978 Mar 11;108(10):363-73.
168 HBAg seropositive and 105 HBAg seronegative liver biopsies were studied for correlations between anti-HBc titers (indirect immunofluorescence method) and tissue expression of HBsAg and HBcAg (immunofluorescence), Dane particles in blood (immune electron microscopy) and inflammatory reaction. 98.8% of the HBAg seropositive patients were positive for anti-HBc. The mean titers showed statistically significant differences mainly between chronic aggressive hepatitis (1:2(11.3)) versus lobular hepatitis (1:2(10.1)), chronic persistent hepatitis (1:2(9.9)) and nonspecific reactive hepatitis (1:2(7.6)). Due to the considerable deviation of titers within the histological groups, however, titers below 1:2(11) are of low diagnostic relevance, whereas titers above 1:2(12) are mainly indicative of chronic aggressive hepatitis, although acute lobular hepatitis with signs of possible transition to chronicity or chronic persistent hepatitis with strong inflammatory activity may occur. Among HBAg seronegative patients 20% were positive for anti-HBc (mean titer = 1:2(7.7)). Among 78 patients also tested for anti-HBs, 10.2% were positive for both anti-HBc and anti-HBs. In an additional 12.8%, anti-HBc was the only marker of past hepatitis B virus infection. Anti-HBs was the only marker in a further 33%. In none of the HBAg seronegative patients and in only 59% of all HBAg seropositive patients, there was an association of anti-HBc with complete virus synthesis as measured by the demonstration of HBcAg in tissue or Dane particles in blood. It is concluded that anti-HBc is not a criterion of infectiosity but a specific, although non-characteristic, marker for HBAg seropositive acute and chronic hepatitis as well as for terminated HBV infection of all possible inflammatory and HBAg expression types.
对168例乙肝表面抗原（HBAg）血清学阳性和105例HBAg血清学阴性的肝活检组织进行了研究，以探讨抗乙肝核心抗体（抗-HBc）滴度（间接免疫荧光法）与乙肝表面抗原（HBsAg）和乙肝核心抗原（HBcAg）的组织表达（免疫荧光法）、血液中 Dane 颗粒（免疫电镜）及炎症反应之间的相关性。98.8%的HBAg血清学阳性患者抗-HBc呈阳性。平均滴度在慢性活动性肝炎（1:2(11.3)）与小叶性肝炎（1:2(10.1)）、慢性持续性肝炎（1:2(9.9)）及非特异性反应性肝炎（1:2(7.6)）之间存在统计学显著差异。然而，由于各组织学组内滴度存在相当大的偏差，滴度低于1:2(11)的诊断相关性较低，而滴度高于1:2(12)主要提示慢性活动性肝炎，尽管也可能出现有向慢性转变迹象的急性小叶性肝炎或炎症活动较强的慢性持续性肝炎。在HBAg血清学阴性患者中，20%抗-HBc呈阳性（平均滴度 = 1:2(7.7)）。在另外78例同时检测了抗-HBs的患者中，10.2%抗-HBc和抗-HBs均呈阳性。另有12.8%的患者，抗-HBc是既往感染乙肝病毒的唯一标志物。抗-HBs是另外33%患者的唯一标志物。在所有HBAg血清学阴性患者中以及仅59%的HBAg血清学阳性患者中，抗-HBc与通过组织中HBcAg或血液中Dane颗粒检测所衡量的完整病毒合成之间存在关联。结论是，抗-HBc不是传染性的标准，而是HBAg血清学阳性的急性和慢性肝炎以及所有可能炎症和HBAg表达类型的已终止乙肝病毒感染的一种特异性（尽管不具有特征性）标志物。
