MULTIPLICATION OF HEPATITIS-B VIRUS IN FULMINANT HEPATITIS-B

The presence in serum of hepatitis B e antigen (HBeAg) and hepatitis B virus DNA, which are each regarded as reflecting multiplication of hepatitis B virus, were looked for 1-5 days after the onset of hepatic encephalopathy in 64 patients with fulminant hepatitis B. HBeAg and hepatitis B virus DNA were found in the serum of only 24 (37%) and 6 (9%) patients, respectively. Hepatitis B virus DNA was absent from the serum in all 13 patients positive for anti-HB. Replication of hepatitis B virus evidently stopped after the onset of hepatic encephalopathy in most of the patients. The view that an enhanced immune response stops the replication was supported. Agents that inhibit viral multiplication would probably not have any effect at this stage of the disease.