key: cord-0007382-wc2sk8xk
authors: Ackermann, Hans-W.; Cherchel, Gérard-L.; Valet, Jean-Paul; Matte, Jean
title: Hollow Hepatitis B Antigen in a Case of Viral Hepatitis
date: 1974-02-03
journal: J Infect Dis
DOI: 10.1093/infdis/129.2.213
sha: 62535fe99074e7dbb71e8c9c69c510181a1b1b0a
doc_id: 7382
cord_uid: wc2sk8xk

The serum from one case of acute hepatitis contained large numbers of hollow particles of hepatitis B antigen (HB Ag). Particles had diameters of 15–20 nm, occurred frequently in compact masses, and were sometimes connected by bridges. This form may be the precursor of normal HB Ag.

The serum from one case of acute hepatitis contained large numbers of hollow particles of hepatitis B antigen (HB Ag). Particles had diameters of 15-20 nm, occurred frequently in compact masses, and were sometimes connected by bridges. This form may be the precursor of normal HB Ag.

The shape of particles of hepatitis B antigen (HB Ag), either rounded or elongated, is well known, and the elongated particles are considered to be the normal morphologic variety. Despite the large number of studies of HB Ag, there are few reports on abnormally shaped HB Ag. Almeida observed crescent-shaped particles [l], Couleru et al. described small particles 11 nm in diameter [2] , and hollow particles were occasionally seen [1, [3] [4] [5] [6] [7] .

While investigating highly purified fractions of HB Ag-positive sera by electron microscopy, we found a serum containing large numbers of hol-low particles. The HB Ag was purified by a fivestep method, including two cycles of centrifugation in CsCI and was studied with a Philips EM 300 electron microscope; details of methods are given elsewhere [8] . The case itself was not unusual. A 19-year-old female with no history of inoculation was hospitalized for 13 days with acute hepatitis. On admission (five days after the onset of disease), biochemical tests gav.e the following results: serum glutamic oxalocetic transaminase, 1238 international units (IU), serum glutamic pyruvic transaminase, 1374 IU, and total and direct bilirubin, 7.5 mg and 6 mg/IOO ml, respectively. A notable feature was a high titer of HB Ag ( > 1024) by complement fixation, whereas counterimmunolectrophoresis showed a titer of 1: 64-1: 128. The patient recovered completely.

The serum contained large numbers of normal "full" particles of HB Ag 22 nm in diameter; most of these were rounded and well separated from each other. Dane particles [7] were extremely scarce and were found only in the first sedimentation gradient fraction. The most interesting finding was the presence of numerous hollow particles. They occurred either isolated or, more often, in three-dimensional clumps or compact masses that were not dissociated by the staining process. In addition, the clumps contained apparently normal particles of HB Ag or an amorphous mass (figure 1). The hollow particles were round or slightly oval with rather thick walls and were generally smaller than normal HB Ag. They measured 15-20 nm in diameter and had 5-10-nm holes. Under favorable conditions hollow particles were seen to be connected by flat bridges (figure 2) or arranged in ringlike structures.

The hollow particles differ from the capsids of Dane particles, which have thin walls and are 27-28 nm in diameter [1, 4, 6, 8, 9] . Because of their association with normal HB Ag, they are believed to be imperfect forms and possible precursors of normal HB Ag. To our knowledge, there is no previous report of hollow HB Ag particles occurring in large numbers and linked by bridges. The present observation lends further weight to the view that HB Ag is not a virus but rather is excess viral coat material [1-3, 6, 9] .

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