Abstract
An enzyme-linked immunosorbent assay (ELISA) was developed to detect subtypic determinants (d, y, w and r) of hepatitis B surface antigen (HBsAg) with monoclonal antibodies in a total of 182 sera of 91 HBsAg positive asymptomatic carriers (ASC, mean age; 18 years old) and 91 HBsAg positive patients with chronic liver disease (CH, mean age; 33 years old) in Japan. In 91 ASC, the number of adr was 68 (74.7%), that of adw was 18 (19.8%), that of ayw was 2 (2.2%), and that of adwr was 3 (3.3%). In 91 CH, the number of adr was 88 (96.7%), that of adw was 1 (1.1%), that of adyr was 1 (1.1%), and that of adwr was 1 (1.1%). Thirty-six (52.9%) in 68 ASC of adr were positive anti-HBe. In contrast, 14 (77.8%) in 18 ASC of adw were positive anti-HBe.
In five (5.7%) in 88 CH of adr, the subtype of adr changed to adwr in acute exacerbation. The quantitive level of subtypic determinant w reached its peak before the peak of serum transaminase, parallel to the quantitive level of HBsAg and binding activity of polymerized human serum albumin receptor on hepatitis B virus particles and DNA-polymerase activity. However, the number of adwr in 91 ASC was 3 (3.3%) with normal level of the serum transaminase.
These results suggest that HBsAg positive carriers of adw seem to become positive anti-HBe earlier than HBsAg positive carriers of adr, and that the compound subtype of adwr doesn't always seem to be associated with liver damage.
