HBeAg/anti-HBe system and cell-mediated immunity in patients with HBsAg-positive chronic active hepatitis.

Determinations of HBeAg, anti-HBe and cell-mediated immune response were carried out in 29 patients with HBsAg-positive chronic active hepatitis. Out of 29 patients with chronic active hepatitis B, 18 were found to be HBeAg positive, 7 anti-HBe positive, and 4 without detectable HBeAg/anti-HBe by radioimmunoassay. The presence of HBeAg in serum (n = 18) was associated with impaired lymphocyte response in 15 patients (83.3%, p less than 0.05). Out of these 15 patients 6 developed cirrhosis within a period of 6 months to 2 years. By contrast, this occurred in only 1 out of 8 HBeAg-negative patients (6 were anti-HBe positive) with normal lymphocyte function. Although HBeAg and depressed cellular immune response in chronic active hepatitis is not necessarily associated with a bad clinical and histological outcome of the disease, these data suggest that, in a number of cases, host cell-mediated immune response seems to be correlated with the presence of HBeAg and the outcome of chronic active hepatitis and, in this respect, HBeAg could assume the significance of a prognostic marker in hepatitis B virus infection.