We investigated the frequency of HBsAg clearance and the possible role of viral superinfection in a long-term follow-up of 184 patients with chronic hepatitis B (CHB). Our subjects were 184 patients with chronic hepatitis B and the follow-up was 12-216 months (mean 66.2 +/- 53.7 months). The investigative methods used were: immunoenzymatic assays for HBV, HCV, HDV, and HIV markers; polymerase chain reaction (PCR) for HBV DNA; and liver biopsy and immunoperoxidase. During the follow-up, 20 of the 184 patients cleared serum HBsAg. A comparison of patients with persistent HBsAg(group I) and of those who cleared this marker (group II) showed a significant difference in mortality (P = 0.002) between the two groups and a tendency to a more severe exacerbation (flare) in group II (P = 0.07). Antibodies to hepatitis C and D virus as well as antibodies to HIV were equally distributed in both groups. Thirteen patients (7.9%) from group I, but none from group II, subsequently developed hepatocellular carcinoma. These results suggest that the frequency of spontaneous clearance of HBsAg during chronic HBV infection is low. No determinant factor for the clearance was found, including the presence of liver cirrhosis. Serum HBV DNA was undetectable by PCR after clearance in 16 out of 17 patients.

In autoimmune hepatitis (AIH), the smooth-muscle an-The determination of antiactin antibody (AAA) is of tibody is specific for polymerized actin. Detection of paramount importance to better characterize the antiantiactin antibody (AAA) has been hampered by techni-smooth muscle antibody (SMA), one of the most imcal problems. We have investigated AAA in 30 sera from portant autoantibodies for the diagnosis of autoimpatients with liver diseases and smooth-muscle anti-mune hepatitis (AIH).1-4 However, the best technique body. AAA was detected by indirect immunofluores-for its determination remains a challenge. Perhaps this

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