Viral Hepatitis, Type B

Abstract

Serial serum samples from immunized and unimmunized persons exposed to the MS-2 strain of hepatitis B virus were tested for DNA polymerase and antibody to hepatitis B core antigen (anti-HBc). First DNA polymerase and then antibody to the core antigen appeared in unimmunized persons after hepatitis B surface antigen and before or at the time of elevated liver enzymes. DNA polymerase persisted for days or weeks in acute cases and for months or years in chronic carriers, whereas antibody to hepatitis B core antigen persisted in all cases. Neither hepatitis B surface antigen, DNA polymerase, nor antibody to core antigen appeared in persons immunized with heat-inactivated MS-2. Hepatitis B surface antigen and DNA polymerase were not detected in those passively immunized with hepatitis B immune globulin, but antibody to core antigen did appear transiently in one. Thus, DNA polymerase appears to identify the period of peak hepatitis B virus replication, antibody to core antigen reflects recent or ongoing virus replication, and both tests will be useful in evaluating the safety and efficacy of future hepatitis B virus vaccines. (N Engl J Med 290:1331–1335, 1974)