PT  - JOURNAL ARTICLE
AU  - C G Trepo
AU  - D Robert
AU  - J Motin
AU  - D Trepo
AU  - M Sepetjian
AU  - A M Prince
TI  - Hepatitis B antigen (HBSAg) and/or antibodies (anti-HBS and anti-HBC) in fulminant hepatitis: pathogenic and prognostic significance.
AID  - 10.1136/gut.17.1.10
DP  - 1976 Jan 01
TA  - Gut
PG  - 10--13
VI  - 17
IP  - 1
4099  - http://gut.bmj.com/content/17/1/10.short
4100  - http://gut.bmj.com/content/17/1/10.full
SO  - Gut1976 Jan 01; 17
AB  - Hepatitis B surface antigen (HBSAg) and antibodies to both the surface and core antigens of the hepatitis B virus (anti-HBS and anti-HBC) have been studied in 64 consecutive cases of fulminant hepatitis. HBSAg was detected by counterelectrophoresis in 23 (35-9%) but by radioimmunoassay in 38 (59-3%). Anti-HBS was detected by passive haemagglutination in 26 (40-6%), coexisting HBSAg and anti-HBS were found in 16 cases (25%). Using an indirect immunofluorescence technique, anti-HBC was found in all of the cases in whom either HBSAg or anti-HBS was present. The highest survival rate was observed in patients with no evidence of HBV infection (31-3%) and was lowest in those who had both HBSAg and anti-HBS detected simultaneously (6-2%). The prognosis of those who exhibited anti-HBS only was no better than those with HBSAg alone. In a further case, transient interruption of the asymptomatic chronic HBSAg carrier state with seroconversion to anti-HBS was associated with the development of a fulminant hepatitis syndrome. The results suggest that an unusually strong and rapid immune clearance of HBSAg may be involved in the pathogenesis of fulminant hepatitis.