Serum Hepatitis B Antigen Particles in various Liver Diseases : Relation to Immunological Tests for Hepatitis B Antigen

Immunological detection of HBAg and the electron-microscopic observation of HBAg particles were performed on 196 serum samples collected from a total of 183 cases consisting of 58 of acute hepatitis, 8 of prolonged hepatitis, 60 of chronic hepatitis, 30 of liver cirrhosis, 21 of hepatoma and 6 of fulminant hepatitis, and the results obtained by both techniques were studied comparatively. As the result, the discrepancy between both techniques was noted in 19.9% (35/196) of the total serum samples, and almost all of the discrepancy was seen in the serum samples which were negative for HBAg by radioimmunoassay but exhibitid the particles electron-microscopically. The incidence of HBAg in various liver diseases determined electron-microscopically was recorded at 63.7% (37/58) for acute hepatitis, at 60% (36/60) for chronic hepatitis including 66.6% (26/39) for aggresive form, at 50% (15/30) for liver cirrhosis and at 71.4% (15/21) for hepatoma, and these values were more than 10% higher than those determined by immunological techniques. These results indicated that electron microscopy was a more sensitive method than immunological tests for detecting HBAg and supported the hypothesis that HBAg may play some role in the development of chronic liver disease and hepatoma.