Two autopsy cases with "acute on chronic" hepatitis B who demonstrated elevated DNA polymerase activity and tested negative for HBV DNA

Abstract

Two patients with anti-HBe positive chronic hepatitis B developed severe hepatitis. Their sera tested positive for DNA polymerase (DNA-P), however, negative for HBV DNA by dot blot hybridization technique. To understand the mechanism of "acute on chronic" hepatitis, we analyzed HBV DNA by Polymerase Chain Reaction (PCR) method, products of DNA-P by agarose gel electrophoresis, and presence of HBc antigen by histochemical assay for liver tissues. HBcAg was not detected in the liver tissues, but HBV DNA tested positive for both sera by PCR. Thus, the quantity of HBV DNA was considered a little. The products of DNA-P demonstrated smear by the gel electrophoresis. Therefore, we concluded that the elevation of DNA-P activity did not come from HBV DNA-P. One of the two cases showed positive for HCV antibody. Understanding of DNA-P assay should be careful for these patients.