[Changes in serum levels of beta 2-microglobulin, neopterin and 2',5'-oligoadenylate synthase activity during clearance of hepatitis B virus with or without acute phase in transaminases].

We have investigated the relation between acute-like transaminase exacerbations and the induction of 2',5'-oligoadenylate (2-5A) synthetase activity, HLA-I associated beta 2-microglobulin and macrophage activated release of neopterin during hepatitis B virus clearance in 70 patients treated or not with interferon. In treated patients who had an exacerbation in ALT during HBV clearance (loss of HBeAg and HBV-DNA from serum), the activity of the enzyme 2-5A synthetase and the level of beta 2 microglobulin increased markedly (p < 0.05). In contrast, in the absence of a peak in ALT during HBV clearance following interferon administration, the levels of 2-5A synthetase activity and neopterin, but not of beta 2-microglobulin, rose significantly (p < 0.05). Neither the non-responder treated patients nor the untreated controls had significant changes in these parameters, irrespective of the transaminase levels. Thus, elimination of viremia after interferon treatment may occur by different pathways as reflected by the presence or absence of acute-like biochemical exacerbations.