Cell-mediated immune responses to purified HBsAg (cellular HBsAb) and to insoluble hepatocyte-surface membranes (IHSM) prepared from rat livers were assayed in 40 patients with chronic hepatitis using the leucocyte-migration test. HBsAg, HBsAb and HBcAb in sera were also detected simultaneously in the same patient.
Cell-mediated immunity to IHSM was found in 37% of patients with chronic persistent hepatitis and in 43% of those with chronic active hepatitis. Cellular immune responses to purified HBsAg were observed in 35% of patients with chronic hepatitis.
Patients with at least one or more of HBsAg, HBsAb, HBcAb and cellular HBsAb were classified as HBV-associated chronic hepatitis group and patients without any of them as HBV-non-associated chronic hepatitis group.
The former group was consisted of 28 out of 40 patients with chronic hepatitis (70%), partly due to a presence of cellular immunity to HBsAg in many HBsAg-negative patients. Out of 16 patients with chronic hepatitis who had cellular response to IHSM, 14 patients (88%) were belonged to HBV-associated chronic hepatitis group. The positive response to IHSM was found in 64% of patients with the positive cellular response to purified HBsAg but in 27% of patients with the negative response to purified HBsAg (P<0.05). Conversely, the positive cellular response to purified HBsAg was observed in 56% of patients with the positive cellular response to IHSM but in 21% of those with the negative response to IHSM (P<0.05).
Furtheremore, there was a significant correlation in degree of the cellular response between to purified HBsAg and to IHSM in a group of HBV-associated chronic hepatitis (r=0.456, n=28, t=2.613, P<0.02). In a group of HBV-nonassociated chronic hepatitis, however, no correlation was found at all. Thus it seems likely that the development of a cellular response to IHSM in patients with HBV-associated chronic hepatitis was closely related with the development of a cellular response to purified HBsAg. These significances were discussed.
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