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Q J Med 1991; 78: 123-134
© 1991 Association of Physicians

research-article

Detection of Hepatitis B Virus DNA Sequences in Liver in HBsAg Seronegative Patients with Liver Disease with and without Anti-HBc Antibodies1

EA FAGAN, FD DAVISON, R TROWBRIDGE, WF CARMAN*, HM SMITH, R TEDDER{dagger} and R WILLIAMS

From the Liver Unit, King's College Hospital, Denmark Hill London *Department of Medicine, St. Mary's Hospital Medical School London {dagger}Department of Virology, Middlesex Hospital Medical School London

Address correspondence to Dr Roger Williams

Accepted for publication 29 August 1990.

Excluding studies from Brechot and co-workers, little support has been found for a role of the hepatitis B virus in the pathogenesis of HBsAg seronegative patients with predominantly chronic liver diseases, including primary liver cancer. In this study liver DNA from 59 predominantly British patients (four cases with paired biopsies, 6–12 months apart) with different, mostly chronic, liver diseases was analysed by molecular hybridization. All were seronegative for HBsAg and serum hepatitis B virus DNA (dot blot hybridization) and their liver diseases were believed to be unrelated to hepatitis B virus infection. Hepatitis B virus DNA was detected in liver of 11 (18.6 per cent) patients; nine had episomal(3.2 Kb) DNA and eight had higher molecular weight bands suggesting integrated forms. Six patients were also seronegative for anti-HBc. Patients of UK and non-UK origin were equally represented. Hepatitis B virus DNA was detected in serum of six of nine patients tested using the polymerase chain reaction. The detection of hepatitis B virus DNA in liver and in serum by this assay in a significant proportion of patients with chronic liver disease, hitherto unsuspected of being hepatitis B virus-related, suggests a possible role for this virus in low- as well as high-prevalence countries.

1This paper was presented in part at the American Association for Study of the Liver, Chicago, October 1989.


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