The presence of hepatitis B virus
DNA in serum was determined in 57 unselected patients during the course from acute to
chronic hepatitis B infection. Forty-six (81%) patients were hepatitis B virus
DNA-positive in the first available serum sample. Generally, hepatitis B virus
DNA was cleared before or at the same time as
HBeAg, but in two patients (4%), hepatitis B virus
DNA could be demonstrated after
HBeAg clearance. One of the latter patients had hepatitis B virus
DNA in the presence of anti-HBe. Both patients became hepatitis B virus
DNA-negative. Seven of the hepatitis B virus
DNA-positive patients received long-term treatment with
prednisone, and three of them continued to be hepatitis B virus
DNA positive for more than 10 years. Among the untreated patients hepatitis B virus
DNA could be detected for up to 7 years, and 10 patients were hepatitis B virus
DNA-positive for three years or more. Twenty-four patients (42%) showed serological signs of delta agent
infection. Hepatitis B virus
DNA clearance was observed in a significantly higher proportion (87%) of delta-infected patients as compared to patients with no
delta infection (45%) (p less than 0.05). In addition patients with
delta infection had a significantly increased hepatitis B virus
DNA clearance rate as compared to patients without delta markers in their serum (p less than 0.01). In one (8%) delta-infected patient, hepatitis B virus
DNA clearance was followed by a fall in
transaminases into the normal range as opposed to results in 86% of patients with pure
hepatitis B (p less than 0.002).