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. 1976 Feb;29(2):94–100. doi: 10.1136/jcp.29.2.94

Distribution patterns of hepatitis B surface antigen (HBsAg) in the liver of hepatitis patients.

M B Ray, V J Desmet, J Fevery, J De Groote, A F Bradburne, J Desmyter
PMCID: PMC475984  PMID: 777039

Abstract

One hundred liver biopsies from 100 hepatitis patients were examined by the indirect immunofluorescent technique for the detection of HBsAg. Of the 60 positive specimens 52 were diagnosed as various types of chronic hepatitis and 8 were acute hepatitis. Four main distribution patterns of HBsAg were obtained: full cytoplasmic fluorescence with diffuse lobular distribution; cytoplasmic fluorescence with spotty distribution; peripheral fluorescence in the cell membrane and/or cell peripheries; and focal cytoplasmic positivity. There was an inverse relationship between the number of positive hepatocytes and the extent of liver cell necrosis. The distribution patterns of HBsAg were distinctive in each type of chronic hepatitis and in acute hepatitis. Homogeneous full cytoplasmic fluorescence, distributed diffusely in the whole liver lobule, was observed in chronic persistent hepatitis and in cirrhosis with little activity whereas peripheral liver cell membrane and/or peripheral cytoplasmic fluorescence associated with cytoplasmic positivity in a smaller number of hepatocytes was a characteristic finding in chronic aggressive hepatitis, active cirrhosis, and acute hepatitis with possible transition to chronicity. Focal cytoplasmic fluorescence was observed in acute hepatitis and a group of biopsies in chronic hepatitis in which HBsAg was detected in the liver but no antigen was detectable in the serum. The results show that the different patterns of distribution of HBsAg in the liver biopsy are helpful for the histological diagnosis of different types of HBAg positive viral hepatitis and are consistent with the hypothesis of the role of specific immune response in the pathogenesis of type B viral hepatitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akeyama T., Kamada T., Koyama M., Abe H. Distribution patterns of hepatitis B antigen in the liver. Immunofluorescence studies. Arch Pathol. 1974 Oct;98(4):252–256. [PubMed] [Google Scholar]
  2. Blumberg B. S., Gerstley B. J., Hungerford D. A., London W. T., Sutnick A. I. A serum antigen (Australia antigen) in Down's syndrome, leukemia, and hepatitis. Ann Intern Med. 1967 May;66(5):924–931. doi: 10.7326/0003-4819-66-5-924. [DOI] [PubMed] [Google Scholar]
  3. Blumberg B. S., Sutnick A. I., London W. T. Australia antigen as a hepatitis virus. Variation in host response. Am J Med. 1970 Jan;48(1):1–8. doi: 10.1016/0002-9343(70)90093-8. [DOI] [PubMed] [Google Scholar]
  4. Caramia F., De Bac C., Ricci G. Virus-like particles within hepatocytes of Australia antigen carriers. Am J Dis Child. 1972 Apr;123(4):309–311. doi: 10.1001/archpedi.1972.02110100041014. [DOI] [PubMed] [Google Scholar]
  5. Cérat G., Richer G., Viallet A., Côté J., Robert J., Turgeon F. Detection of Australia antigen in liver biopsies by immunofluorescence. Can Med Assoc J. 1973 Apr 21;108(8):981–984. [PMC free article] [PubMed] [Google Scholar]
  6. Deutsch G. F., Spence L. Virus-like particles in the liver and their relationship to Australia antigen. Lancet. 1972 Feb 19;1(7747):447–447. doi: 10.1016/s0140-6736(72)90906-3. [DOI] [PubMed] [Google Scholar]
  7. Dudley F. J., Fox R. A., Sherlock S. Cellular immunity and hepatitis-associated, Australia antigen liver disease. Lancet. 1972 Apr 1;1(7753):723–726. doi: 10.1016/s0140-6736(72)90234-6. [DOI] [PubMed] [Google Scholar]
  8. Gudat F., Bianchi L., Sonnabend W., Thiel G., Aenishaenslin W., Stalder G. A. Pattern of core and surface expression in liver tissue reflects state of specific immune response in hepatitis B. Lab Invest. 1975 Jan;32(1):1–9. [PubMed] [Google Scholar]
  9. Hadziyannis S., Gerber M. A., Vissoulis C., Popper H. Cytoplasmic hepatitis B antigen in "ground-glass" hepatocytes of carriers. Arch Pathol. 1973 Nov;96(5):327–330. [PubMed] [Google Scholar]
  10. Joseph B. S., Oldstone M. B. Antibody-induced redistribution of measles virus antigens on the cell surface. J Immunol. 1974 Oct;113(4):1205–1209. [PubMed] [Google Scholar]
  11. Krawczyński K., Nazarewicz T., Brzosko W. J., Nowoslawski A. Cellular localization of hepatitis-associated antigen in livers of patients with different forms of hepatitis. J Infect Dis. 1972 Oct;126(4):372–377. doi: 10.1093/infdis/126.4.372. [DOI] [PubMed] [Google Scholar]
  12. Lampert P. W., Joseph B. S., Oldstone M. B. Antibody-induced capping of measles virus antigens on plasma membrane studied by electron microscopy. J Virol. 1975 May;15(5):1248–1255. doi: 10.1128/jvi.15.5.1248-1255.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Morphological criteria in viral hepatitis. Review by an international group. Lancet. 1971 Feb 13;1(7694):333–337. [PubMed] [Google Scholar]
  14. Nelson J. M., Barker L. F., Danovitch S. H. Intranuclear aggregates in the liver of a patient with serum hepatitis. Lancet. 1970 Oct 10;2(7676):773–774. doi: 10.1016/s0140-6736(70)90247-3. [DOI] [PubMed] [Google Scholar]
  15. Nielsen J. O., Nielsen M. H., Elling P. Differential distribution of Australia-antigen-associated particles in patients with liver diseases and normal carriers. N Engl J Med. 1973 Mar 8;288(10):484–487. doi: 10.1056/NEJM197303082881002. [DOI] [PubMed] [Google Scholar]
  16. Nielsen J. O., Nielsen M. H., Reinicke V. Absence of Dane particles in Au-antigen carriers with a histologically normal liver. Lancet. 1972 Oct 28;2(7783):934–934. doi: 10.1016/s0140-6736(72)92585-8. [DOI] [PubMed] [Google Scholar]
  17. Popper H., Schaffner F. The vocabulary of chronic hepatitis. N Engl J Med. 1971 May 20;284(20):1154–1156. doi: 10.1056/NEJM197105202842011. [DOI] [PubMed] [Google Scholar]
  18. Prince A. M. An antigen detected in the blood during the incubation period of serum hepatitis. Proc Natl Acad Sci U S A. 1968 Jul;60(3):814–821. doi: 10.1073/pnas.60.3.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ray M. B., Desmet V. J., Fevery J., De Groote J., Bradburne A. F., Desmyter J. Hepatitis B surface antigen (HBsAg) in the liver of patients with hepatitis; a comparison with serological detection. J Clin Pathol. 1976 Feb;29(2):89–93. doi: 10.1136/jcp.29.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ray M. B., Desmet V. J. Immunofluorescent detection of hepatitis B antigen in paraffin-embedded liver tissue. J Immunol Methods. 1975 Jan;6(3):283–289. doi: 10.1016/0022-1759(75)90071-x. [DOI] [PubMed] [Google Scholar]
  21. Ray M. B., van Damme B., Desmet V. J. Evaluation of a modified fluorescent technique for the detection of Australia antigen in liver tissue. J Immunol Methods. 1974 Jan;3(1):47–52. doi: 10.1016/0022-1759(74)90032-5. [DOI] [PubMed] [Google Scholar]
  22. Reed W. D., Eddleston A. L., Williams R. Immunopathology of viral hepatitis in man. Prog Med Virol. 1974;17(0):38–76. [PubMed] [Google Scholar]

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