In order to establish the virological signifkance of HBeAg eubtypes (HBeAg/l and HBeAg/2) during hepatitis B virus infedon, HBsAg, HBeAg and hepatitis B virus DNA in serum and HBcAg in liver were determined quantitatively in relation to the detection of HBeAg sobtypes in agar gel diffusion. Thirty-eight chronic EBsAg carriers with HBeAg, including 16 nonspecific reactive hepatitis, 8 chronic persistent hepatitis, 11 chronic active hepatitis and 3 liver cirrhosis, who were seen at Tohoku University Hospital from 1983 to 1986, were examined. Signifhntly larger amounts of HBeAg, EBeAg and hepatitis B virus DNA in serum and EBcAg in liver were found in patients positive for both HBeAg/l and HBeAg/2 in serum than in thoee positive for only EBeAg/l or negative for both subtypes. These d t a suggest that the presence of HBeAg/2 in serum may r e b t the Occurrence of active viral replication.
When the detection pattern of HBeAg subtypes was examined during serial follow-up for at least 1 year, three groups of patients were classified with respect to the preaence of HBeAg/2, i.e., Type I, consistently positive for EBeAg/2; Type II, consistently negative for EBeAg/2, and Type 111, intermittently positive for HBeAg/Z. More than 80% of Type I patients were histologically diagnosed having as nonspecific reactive hepatitis, while more than 80% of Type I1 and I11 patients had more progressive liver diseases such as chronic persistent hepatitis, chronic active hepatitis and liver cirrhaeis. Theme results suggest that the serial examination of HBeAg subtypes in serum may be important for more detailed evaluations of type B hepatitis.
Since its discovery as the third hepatitis B virus (HBV)-specific antigen/antibody system (l), the hepatitis B e antigen (HBeAg)/antibody against HBeAg (anti-HBe) system has been proven to have diagnostic and prognostic values in type B hepatitis. The infectivity of HBV is higher in HBeAg-positive sera than in negative sera ( 2 4 , and patients with chronic type B hepatitis positive for HBeAg are considered to have a more progressive illness (5-7).