The diagnostic significance of intrahepatocellular hepatitis-B-surface-antigen (HBsAg), hepatitis-B-core-antigen (HBcAg) and IgG for the classification of inflammatory liver diseases. (Studies on HBsAg-positive and -negative patients)

Abstract

Liver biopsies of patients with inflammatory liver diseases and clinically healthy HBsAg-carriers were examined for presence of intracellular HBsAg, HBcAg and IgG by direct immunofluorescence. The studies revealed the following results: 1. In most cases healthy HBsAg-carriers had HBsAg in the cytoplasm, but they did never show HBcAg in the nuclei of hepatocytes. 2. In the early phase some patients with HBsAg-positive acute hepatitis had HBcAg and/or HBsAg in their hepatocytes. In a normal course with complete recovery the immunoelimination may clear either phenomenon at variable stages of the disease. 3. Cases one year after complete recovery of acute virus B-hepatitis had no HB-components in their liver tissue. 2 cases without immunoelimination of HBsAg developed chronic active hepatitis within one year and had HBcAg in their liver cell nuclei. 4. Patients with HBsAg-positive CAH and highly inflammatory activity had HBcAg in the nuclei and a low percentage of cells with HBsAg in the cytoplasm of hepatocytes. HBsAg-negative cases with CAH never had HB-components in their tissue. 5. Patients with HBsAg-positive and -negative CAH in complete remission never had HBcAg and HBsAg in their hepatocytes. 6. Most cases with HBsAg-positive acute hepatitis and chronic active hepatitis positive for HBcAg had also IgG in the same liver cell nuclei. The coincidence of this finding gives strong evidence for the presence of anti-HBc in these liver cell nuclei. The importance of this finding for the course of the disease is unknown.