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Hepatitis-assoziiertes Antigen (HAA): Klinische und immunologische Bedeutung

Hepatitis-associated antigen: Clinical and immunological significance

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Summary

Hepatitis-associated antigen (HAA) particles concentrated by isopycnic centrifugation have a modal diameter of approximately 200 Å. HAA resembles some viruses in size, lipid content and density, but contains no RNA or DNA. It seems likely that it is chiefly an empty virus coat.

Patients with viral hepatitis show a variable frequency of positive tests for HAA depending not only on differences in the number of samples taken per patient and on the stage of the disease but also on the technique used for measuring HAA.

The frequency of HAA varied from 13–95% for cases of acute serum hepatitis. Cases with chronic persistent hepatitis were found to be positive in 0–80%, cases of chronic active hepatitis had positive tests for HAA in 0–40%, of postnecrotic cirrhosis in 18–44% and of cryptogenic cirrhosis in 0–25%.

Almost all reported patients with autoimmune hepatitis showed no positive HAA-test. Differentiation of chronic active cases into “HAA positive” and “autoimmune” ones may prove to be valuable prognostically.

Antibodies to HAA (anti-HAA) were rarely detected during the course of acute or chronic hepatitis infection but evidence was obtained of circulating complexes during the acute phase of the illness. The significance of antigen-antibody complexes is discussed with respect to severity and duration of hepatitis and it is pointed out that certain of the multisystem manifestations of hepatitis may be immune in nature.

Zusammenfassung

Das Hepatitis-assoziierte (Australia)-Antigen (HAA) ist als Partikel von etwa 200 Å Größe aus dem Serum isolierbar. Man vermutet, daß es sich um ein Virus-Hüllen-Lipoprotein handelt.

HAA war bei Fällen mit akuter Serum-Hepatitis in 13–95% nachweisbar. Sein Nachweis ist spezifisch für diese Krankheit. Bei der persistierenden Hepatitis waren die Teste von 0–80%, bei der chronisch aggressiven Hepatitis von 0–40%, bei der posthepatitischen Cirrhose von 18–44% und bei der kryptogenen Cirrhose von 0–25% positiv. Der Zeitpunkt des Testes in Abhängigkeit zum Krankheitstag oder -stadium und die Art der angewandten Methode bestimmen wesentlich die Nachweisfrequenz von HAA.

Bei autoimmunen Hepatitiden scheint das HA-Antigen äußerst selten oder überhaupt nicht vorzukommen.

Das Auftreten von Antikörpern (anti-HAA) im Anschluß an die Serumhepatitis wurde nur selten beobachtet. Dagegen konnten Immunkomplexe im Verlauf einer Hepatitis aus dem Serum isoliert werden. Die mögliche klinische Bedeutung dieser Immunkomplexbildung für den Verlauf und die Prognose der Hepatitis wird abschließend diskutiert.

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  1. Medizinische Universitätsklinik Tübingen, Germany

    P. A. Berg

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Berg, P.A. Hepatitis-assoziiertes Antigen (HAA): Klinische und immunologische Bedeutung. Klin Wochenschr 50, 125–138 (1972). https://doi.org/10.1007/BF01486937

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