Circulating hepatocyte membrane-specific autoantibodies in chronic active hepatitis type B. Relation to virus replication activity and liver cell necrosis.

Sera from two groups of untreated HBsAG-positive patients with chronic active hepatitis on liver biopsy were tested for antibodies to liver cell membrane antigens (liver-specific protein, LSP; and liver membrane antigen, LM-Ag). Among the 14 HBeAg-positive cases, seven (50%) were positive for anti-LSP, whereas only two (13%) of 15 anti-HBe-positive cases circulated this antibody. Liver membrane autoantibody (LMA) was detected only in two sera from delta-positive patients (1 HBeAg positive and 1 anti-HBe positive). Anti-LSP-positive patients presented transaminase values significantly higher than those of the negative cases. Our data do not support the hypothesis that a liver-specific autoimmune mechanism plays a significant role in the immunopathogenesis of liver cell necrosis in anti-HBe-positive chronic active hepatitis type B. The relationship between hepatocyte necrosis and anti-LSP antibody response is confirmed.