The presence of hepatitis B ‘e’ antigen (HBeAg) and its antibody (anti-HBe) was evaluated by radioimmunoassay (RIA) in various groups of HBsAg-positive patients. HBeAg was present in the majority of the sera from patients with acute viral hepatitis at the onset of clinical symptoms and disappeared after 1 year. Almost all hemodialysis patients had HBeAg in their sera. 40% of the patients who had chronic active hepatitis and 50% with chronic persistent hepatitis had HBeAg with no relationship to the inflammatory activity of the disease evaluated by the presence of mononuclear infiltration in liver biopsy. The comparison between the presence of HBeAg and Dane particle-associated DNA-polymerase activity showed that HBeAg was consistently found in almost all the sera which presented DNA-polymerase activity. HBeAg, as determined by RIA, may therefore be useful in the screening of highly infective patients with elevated viral replication.

Screening tests for hepatitis B virus (HBV) markers were performed in 266 hematologic patients in order to evaluate the role of transfusion therapy in HBV infection and to identify other possible causes of the high rate of HBV markers positivity in oncohematologic units. As control groups we tested 99 nonhematologic polytransfused patients, 66 nonhematologic, nontransfused inpatients with various diseases and 72 subjects randomly selected from the general population. Higher HBV markers prevalence was found in hematologic patients, nonhematologic polytransfused patients and nonhematologic, nontransfused inpatients than in the general population. HBV markers prevalence correlated with the length of hospitalization in all inpatients studied. Our data suggest that hospital admission is a major factor in HBV transmission in hematologic patients and in other inpatients studied. Blood transfusions represent a risk factor only when utilized as chronic treatment.