Hepatitis-associated antigen and antibody in Uganda: correlation of serological testing with histopathology.

Histopathological findings in 91 Ugandan patients with cirrhosis were studied in relation to serological tests for the hepatitis-associated antigen (H.A.A.) and antibody (anti-H.A.A.). H.A.A. was present in 30 (32.9%) of the 91 patients as opposed to 7 (3.1%) out of 224 controls drawn from the same population (P<0.001). Younger subjects and males were more frequently positive. There was no difference in the presence of anti-H.A.A. between patients and controls. Correlation of the results of serological testing with histopathological features showed that macronodular ("posthepatitic," "postnecrotic") types of cirrhosis, which predominate in Uganda, were associated with the presence of H.A.A. but that the much less common micronodular ("nutritional," fatty, portal) type of cirrhosis was not. Evidence was found, on the other hand, for a direct role of alcoholism in the latter. Detailed histological analysis also showed two types of cellular change-liver cell swelling and dysplasia-to be associated with the presence of H.A.A. The data suggest an aetiological role for H.A.A. in most cases of cirrhosis in Uganda and these may be identified by histological criteria.