ANALYSIS OF HEPATITIS B VIREMIA AMONG HBS ANTIGEN-NEGATIVE PEOPLE (MUTUAL REACTION BETWEEN HBV AND CYTOTOXIC T CELLS)

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It has been thought that hepatitis B virus is completely cleared from body of immunocompetent adults after acute hepatitis B.However, recent studies have shown that low levels of viremia continue for long after acute, self-limited hepatitis B.These suggest that a substantial number of people with a previous history of acute, self-limited infection have low levels of HBV in their blood. We have studied the positivity of serum HBV-DNA among 50 blood donors who were negative for HBs antigen (HBsAg) and positive for hepatitis B core antibody (anti-HBc). HBV-DNA was detected in 19 of 50 (38%) of donors. In 8 of the 19 donors have HBV-DNA in the non-immunoglobulin-bound (non-immune-complex) form. Five of the eight donors have HBV-DNA also as immunoglobulin-bound (immune-complex) form. The remaining 11 have HBV-DNA in the immunoglobulin-bound (immune-complex) form alone. Levels of HBV-DNA among HBV-DNA-positive donors were similar to those in the remission phase of acute hepatitis B.Digestion of sera with DNase 1 did not change the levels of HBV-DNA.Amino acid sequences of preS-S region were analyzed in six donors (three with subtype adr and three with subtype adw). Although each donor had different sequence, no common mutation was found. No mutation was found in the major hydrophobic region (MHR). These suggest that some HBsAg-negative, anti-HBc-positive blood donors have infectionsHBV in their sera. We analyzed the effect of such "occult" HBV on hepatocarcinogenesis among HCV-related and non-B, non-C hepatocellular carcinoma (HCC) cases. The effect among HCV-related HCC cases was low. The effect among non-B, non-C HCC cases should be carefully analyzed because genomic structure of such cases was different from that of blood donors.