[Development of chronic active hepatitis of the autoimmune type following hepatitis B virus infection with HBSAg-persistence. 4 case reports].

Two female and two male patients aged of 26, 27, 36 and 46 years with HBsAg-positive chronic active hepatitis (CAH) are presented. The liver disease showed a marked progression with transition to cirrhosis in spite of seroconversion from HbeAg to Anti HBe in three cases. All four patients developed serological markers recognized as typical for the autoimmune type of CAH, such as hypergammaglobulinemia with appreciable elevation of IgG concentrations, antinuclear antibodies and liver membrane antibodies. Furthermore all four patients were positive for the histocompatibility antigen B8. These cases indicate that in genetically predisposed individuals hepatitis B viruses can induce autoimmune processes responsible for the progression of hepatic inflammation. In view of the therapeutic implications it is important to recognize patients with liver disease taking such a course.