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Cellular cytotoxicity of peripheral blood lymphocytes against autologous hepatocytes was studied in 9 patients with HBeAg positive and 8 patients with anti-HBe positive chronic hepatitis B. In the HBeAg positive group a greatly increased cytotoxicity of 41 +/- 7% (mean +/- SEM) was found, in contrast the moderately increased cytotoxicity in anti-HBe positive cases of 15 +/- 5% was clearly different (p = 0.005). The different cytotoxicity values could not be explained on the basis of the histological classification, but seemed to correlate at least to some degree to the aminotransferase levels. The cytotoxic activity resided in both T cell and non-T cell enriched lymphocyte compartments. Our findings may provide an explanation for the poor prognosis of HBeAg positive patients with chronic hepatitis B in contrast to their anti-HBe positive counterparts.
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