Detection of hepatitis B surface antigen by a monoclonal radioimmunoassay in the serum of alcoholic patients

The presence of HBV infection has been retrospectively assessed using monoclonal radioimmunoassay (M-RIA) in the sera of 269 alcoholics. There were three subjects with normal liver, 92 had steatosis, 32 had fibrosis, 15 had acute alcoholic steatosis and 127 had cirrhosis. The HBsAg M-RIA was performed by the sandwich method using high affinity IgG and IgM monoclonal antibodies. The M-RIA was more sensitive for detection of HBV when compared with conventional RIA, the former detecting 15 out of 269, the latter detecting five out of 269 (5.6% and 1.9% respectively; P= 0.02). Among the 264 patients negative for conventional RIA, the prevalence of a positive M-RIA test was no different between patients who lacked HBV related antibodies (seven out of 196; 3.6%) compared with patients with at least one antibody (three out of 68; 4.4%). The prevalence of HBsAg detected by M-RIA was higher in alcoholic patients with cirrhosis (9.4%) compared with patients without cirrhosis (2.1%; P < 0.01). These results suggest that all alcoholic patients could have a low production, or an abnormal expression, of HBV or could be infected by an hepatitis B variant virus. HBV or an hepatitis B variant virus could have in some cases a causative role in the pathogenesis of cirrhosis.