Chronic active hepatitis of hepatitis B and non-A, non-B etiology. Immunohistochemical localization of hepatitis B core antigen in a series of needle biopsies.

Hepatitis B core antigen (HBcAg) was immunohistochemically demonstrated in 19 of 30 needle liver biopsies (63%) of chronic active hepatitis (CAH) from 15 of 24 patients (63%) whose serum contained hepatitis B surface antigen (HBsAg). The percentage of hepatocytes with nuclear and/or cytoplasmic immunoreactivity was quantified in each biopsy specimen, and these percentages were then compared with the amount of HBsAg and the degree of inflammation within the biopsy specimen. The percentage of HBcAg-positive hepatocytes in a biopsy specimen was greatest in those specimens that contained the most HBsAg, although this finding was not statistically significant. The percentage of HBcAg-positive hepatocytes was greatest in those specimens having the least inflammatory activity, and this was statistically significant (P less than .01). Also, the percentage of biopsy specimens containing HBcAg was increased in those groups with lesser inflammatory activity (P less than .01). By staining for both HBcAg and HBsAg, the detection rate of hepatitis B (HB)-related antigens rose to 27 of 30 biopsies (90%) in 22 of 24 patients (92%).