Hepatitis B Surface Antigen Circulating Immune Complexes (HBsAg-CICs) in Patients with Bleeding Disorders

Abstract

Approximately 90% of 67 multi-transfused patients with bleeding disorders were positive either for anti-HBs (85%) or HBsAg (4.5%). Using a polyethylene glycol trypsiniza- tion assay, we found HBsAg-containing specific circulating immune complexes (HBsAg-CICs) in 3 of the 57 HBsAg-negative haemophiliacs possessing anti-HBs. The occurrence of HBsAg- CICs may be a regular event in the conversion phase of HBs infection. Circulating immune complexes as detected by the anticomplementary assay were found in 32 of the 67 (48%) patients.

Clotting factor concentrates and immune function in haemophilic patients

“…Similar ®ndings have more recently been noted in haemophilic patients exhibiting aggressive hepatitis C infection [30]. Additionally, HIV appears to progress more rapidly in patients co-infected with HBV and cytomegalovirus [29,31,32]. Conversely, HCV appears to replicate more rapidly in patients infected with HIV, accounting for the more rapid progression of liver disease in HIV-positive patients [33,34].…”

“…This virus not only destroys CD4+ cells, but also interferes with CD4+ cell interactions with CD8+ cells, B cells and macrophages; and alters T‐cell cytokine release and impairs the response of other cells to cytokines [24–28]. Chronic hepatitis B virus (HBV) infections are associated with CICs, decreased CD4+ counts and CD4+/CD8+ ratio, and B‐cell abnormalities [29]. Similar findings have more recently been noted in haemophilic patients exhibiting aggressive hepatitis C infection [30].…”

Modeling the dynamics of hepatitis B infection, immunity, and drug therapy

“…87 Immune complexes, however, are present much earlier in both acute and chronic disease suggesting that the antibody is being produced before resolution and may be involved in its success. [88][89][90] To determine the antibody's contribution to mediating virus clearance, the interaction between HBsAb and HBsAg on the surfaces of both free virus and subviral particles (SVP) was considered. Subviral particles are empty non-infectious particles that have HBV proteins on their surface, but do not contain nucleocapsid protein and viral nucleic acids.…”

“…Free antibody against surface antigen HBsAg (HBsAb) is not measured until after virus clearance . Immune complexes, however, are present much earlier in both acute and chronic disease suggesting that the antibody is being produced before resolution and may be involved in its success . To determine the antibody's contribution to mediating virus clearance, the interaction between HBsAb and HBsAg on the surfaces of both free virus and subviral particles (SVP) was considered.…”