Hepatitis B surface antigen circulating immune complexes (HBsAg-CICs) in patients with hepatitis B and asymptomatic HBsAg carriers.

The PEG-trypsinization assay detected HBsAg-CICs in 31 out of 44 (70%) patients with acute hepatitis B, in five out of 107 (5%) asymptomatic HBsAg carriers and, in addition, in both patients with HBsAg-positive chronic liver disease. A close correlation between the levels of HBsAg-CICs and disease activity was observed. The clinical course, parameters of liver function tests and outcome of the disease in patients without HBsAg-CICs (group A) and in patients with transient HBsAg-CICs (group B) were essentially similar. In contrast, patients with persistent HBsAg-CICs (group C) had a poor prognosis, particularly those who received corticosteroids. The method appeared to be a valuable tool in monitoring disease activity and prognosis, and in evaluating the efficacy of corticosteroid treatment. The role of HBsAg-CICs in the pathogenesis of liver damage and clearance of circulating HBsAg is discussed.