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The incidence and amount of immunoglobulin (Ig)-bound hepatitis B associated surface antigen (HBs) has been determined in various forms of hepatitis B, using radioimmunological techniques. Both the total concentration of HBs and that of Ig-bound HBs were measured in serum samples from 54 patients with acute hepatitis B, 28 with chronic hepatitis and 28 healthy chronic carriers. The following observations were made: (1) Ig-bound HBs was detected in 79% of patients with acute hepatitis B in one or several samples; the highest level of Ig-bound HBs was observed 60-120 days after the onset of jaundice, while the total amount of HBs was progressively decreasing. (2) Ig-bound HBs was detected in 46% of 28 patients with chronic hepatitis. This frequency was higher in patients with chronic aggressive hepatitis (75%) than in patients with chronic persistent hepatitis (33%). The mean levels of total HBs and Ig-bound HBs are more significantly increased in patients with chronic aggressive hepatitis than in patients with chronic persistent hepatitis or healthy carriers. (3) Ig-bound HBs was detected in 46% of healthy chronic carriers. (4) The persistence of Ig-bound HBs in serum was not related to the antigen sub-type. (5) Extra-hepatic manifestations suggestive of an immune complex disease were observed in only 2 of 31 patients with chronic persistence of Ig-bound HBs. These data suggest that small amounts of HBs-antibody complexes may persist in circulating blood without always being harmful for the host.
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