Immunohistochemical patterns of hepatitis B surface antigen (HBsAg) in patients with hepatitis, renal homografts recipients and normal carriers.

A series of 180, Bouin-fixed and paraffin embedded liver biopsies obtained from 147 patients was investigated for the presence of hepatitis B surface antigen (HBs) by histochemical and indirect immunofluorescence techniques. A comparison between orcein staining and Masson's trichrome preparations for ground glass hepatocytes, showed that immunofluorescence was both the more reliable and the more specific method for detection of HBsAg in liver tissue. The ability to perform this technique on paraffin sections facilitates systematic studies and allows retrospective work-up. IF-HBs positive hepatocytes were found in approximately two thirds of all HBs-positive patients in their serum, but never seen in HBs-negative patients. HBs-positive cells were observed in healthy chronic carriers and in all forms of chronic hepatitis, but never in acute HBs-positive hepatitis. In patients treated with chronic hemodialysis and in renal homograft recipients, the incidence of positive cells was higher than in the chronic hepatitis groups; this could be correlated with the duration of antigenemia at the time of biopsy.