228 ACUTE HEPATIC FAILURE AND HEPATIC REGENERATION. POSSIBLE IMPLICATIONS OF A LIVER GROWTH FACTOR. J.J. Dfaz-Gil, R. Garcfa-Ca~ero, G. S~nchez, C. Trilla. M.A. Guerra, P. Escart[n* Departments of Experimental Biochemistry and *Gastroenterology, Clinica Puerta de Hierro, 28035 Madrid, Spain

We purified and characterized a liver growth factor from plasma of subjects with acute viral hepatitis which was very similar to a liver mitogenic factor previously purified from rats by our group (Biochem J 235:49-55, 1986; Hepatology 6: 658-661, 1986; Hepatology 6:679, Abstr 2, 1986). The purpose of this study was to determine the possible implication of this h-LGF in acute hepatic failure.

Plasma was obtained from three patients of 20-30 years of age with evidence of virus B in serum, AST and ALT higher than 2000 UI/I, grave coagulopathy and grade IV hepatic coma, all of whom died. As controls, we studied five age-matched cases of acute viral hepatitis who recovered.

The determination of activity of h-LGF was performed "in vivo" by injection into mice, and "in vitro" by addition to rat primary liver cell cultures, measuring its effect on DNA synthesis by incorporation of 3H-thymidine.

In the control group, the "in vivo" activity of h-LGF, measured in the first week of diagnosis, had a value of 7138 ± 921 UA of h-LGF/mg prot. In the subjects with acute hepatic failure, the value was 650 ± 70 UA of h-LGF/mg prot, representing 9% of the activity observed in the control group. The "in vitro" activity of h-LGF in the control group reached a maxi- mum at 7.5 ng h-LGF/ml, but was null in one case of acute hepatic failure, and even had an inhibitory effect at the same concentration of h-LGF in two cases.

Conclusions: The low or null activity of h-LGF may support the notion of a lack of hepat- ic regeneration as a factor in the pathogeny of acute hepatic failure. On the other hand, the low activity of h-LGF in the moment of diagnosis could indicate a poor prognosis in the evolution of acute viral hepatitis.

229 RESPONSE TO HBV VACCINE IN SUBJECTS WITH LOW-TITER ANTI-HBsAG

V. Oi Ciommo,C. Concato,G. Catania Bambino GesO Hospital - Rome

The meaning of low levels of anti-HBs is disputed,and their "protective" role is uncerta- in. We investigated the response to anti-HBV vaccine in 22 health-workers with t iters of anti-HBs lower than 20 mU.I./ml. (I.E.A. Sorin);16 of them were also anti-HBc positive (none with IgM anti-HBc). None had received anti-HBV globulins. Anti-HBs was tested on days lO and 30 after the f i rst dose of Hevac-B Pasteur (5 micro- grams subcutaneously). Only two subjects disclosed a "booster"-type response,defined as more than double of the starting anti-HBs t i ter ;both were positive for anti-HBc. Conclusions: candidates to anti-HBV vaccination with low levels of anti-HBs should not be excluded from this procedure,also i f anti-HBc positive.

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