Prognostic value of HBsAg/IgM complexes in hepatitis B patients: nature of the proteins involved

HBsAg/IgM complexes as a prognostic marker of chronicity in acute hepatitis B virus infection

A simple radioimmunoassay for the detection of HBsAg/IgM complexes is described. 52 patients with acute hepatitis B infection were tested, 35 with self-limiting disease (group I) and 17 who became chronic carriers (group II). In the first sampling, taken during the early clinical phase, 24/35 patients (69%) in group I and 16/17 (94%) impending chronic carriers had detectable HBsAg/IgM complexes. The mean s/n values were significantly higher (p less than 0.01) in the group of chronic carriers. In the second sampling, taken with a mean of 31 and 39 days after the first samples in the first and second group, respectively, 2/35 (6%) and 15/17 (88%) were positive for HBsAg/IgM complexes (p less than 0.001). A comparison of HBsAg/IgM complexes results with the detection of HBeAg/anti-HBe showed that 7/14 (50%) patients with acute self-limiting disease lost their complexes before converting to anti-HBe. In the group of chronic carriers, HBeAg was generally lost before or at the same time as the HBsAg/IgM complexes (2.5 months to greater than 9 years after the onset of infection). The method described is easy to perform and could be entered into routine testing of patients with a newly acquired hepatitis B virus infection as an additional prognostic marker, complementing the HBsAg/anti-HBs and the HBeAg/anti-HBe systems.