Serum titers of pre-S(2) antigen in patients with acute and chronic type B hepatitis: Relation to serum aminotransferase activity and other hepatitis b virus markers

✍ Scribed by Kiyohiko Kurai; Shiro Iino; Kazuhiko Koike; Keiji Mitamura; Yasuo Endo; Hiroshi Oka

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 503 KB
• Volume: 9
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840090202

✦ Synopsis

The peptide which is encoded by the pre-S(2) region of hepatitis B virus DNA, the pre-S(2) antigen, was determined quantitatively by an enzyme immunoassay system employing monoclonal antibodies. The prevalence and titer of pre-S(2)Ag were 91.9% (91/99) and 10,356 2 19,053 units (mean f S.D., arbitrary units) for hepatitis B e antigen (HBeAg)-positive patients with acute and chronic HBV infection and 86.0% (74/86) and 952 f 1,565 units for HBeAg-negative subjects. In four patients with acute hepatitis B, pre-S(2)Ag titers changed in parallel with HBV DNA levels, and the disappearance of pre-S(2)Ag from serum was associated with a rapid fall of ALT levels into the normal range, whereas the fluctuation of pre-S(2)Ag titer correlated with persistence of ALT elevations. In all of the 19 episodes of acute exacerbation of hepatitis which occurred in nine patients with chronic active hepatitis B, a significant elevation of pre-S(2)Ag titer was observed, closely overlapping an increase or appearance of HBV DNA, and its peak preceded peaks of ALT by 1 to 11 weeks (mean f S.D. = 4.26 f 2.57 weeks). These observations suggest that quantitative measurement of pre-S(2)Ag would be useful for estimation of the magnitude of HBV replication and would help predict the prognosis of acute hepatitis B and of acute exacerbation in chronic hepatitis B.

A receptor site for polymerized human serum albumin (poly-HSA) exists in proteins expressed on the surface of the hepatitis B virus (HBV) particle (1) and, in particular, on the peptide encoded bv the pre-S(2) region of HBV DNA (2, 3). Similar receptors have been found in hepatocytes (4-6). These observations have led to a hypothesis that this poly-HSA receptor might mediate the attachment of HBV t o hepatocytes (1, 71. Furthermore, both in uiuo (8) and in wtro (9, 10) experiments have demonstrated higher antigenicitv of the pre-S(2)