Evidence for phasic sequences in nuclear HBcAg formation and cell membrane-directed flow of core particles in chronic hepatitis B.

Seven liver biopsies (6 chronic aggressive hepatitis B, 1 kidney transplant recipient with chronic persistent hepatitis B) are described showing differential distribution patterns of HBcAg in liver cells (with gradual transitions): pure nuclear, mixed nuclear/cytoplasmic, and pure cytoplasmic (diffuse and/or submembraneous). This was combined with spotty expression of HBsAg (cytoplasm and liver cell membrane) and with Dane particles (DP) in blood. A phasic nuclear formation and release of cores from the nucleus and of DP from the cell, respectively, is suggested. Electron microscopy (EM) of one biopsy indicates a secretory disturbance as a possible cause for HBcAg accumulation in liver cells the tolerance of which is attributed to immunosuppression therapeutically induced in 4 patients and suspected in 3 (2 dialysis patients, 1 spontaneous chronic aggressive hepatitis B).