[Relevance of immunofluorescence microscopy for diagnosis and prognosis of chronic hepatitis B (author's transl)].

109 patients with hepatitis B infections had 162 biopsies of the liver. The specimens obtained were investigated microscopically; at the same time existence and pattern of distribution of HBs and HBc antigens were looked for by immunofluorescence microscopy. In cases with a histologically established diagnosis of chronic aggressive hepatitis (CAH) the following patterns could be found: (a) focal occurrence of HBc in all cases, (b) pure cytoplasmatic HBs fluorescence (HBs type I), (c) pronounced HBs fluorescence at the cell membrane (HBs type II), or (d) pronounced HBs fluorescence at the cell membrane combined with cytoplasmatic HBs fluorescence in focal areas (HBs type III). The 3 HBs types could be associated with different clinical courses of CAH. A pure cytoplasmatic HBs fluorescence without HBc fluorescence could be found in about two thirds of the cases, which had been diagnosed as chronic persistent hepatitis (CPH) established by the first microscopic examination of the biopsy specimen. All cases deviating from this pattern could be classified at a later date as CAH also by histological criteria. In 25% of the cases the clinical course was protracted, the histological diagnosis having been at first: residual changes after acute hepatitis; in these cases the pattern of distribution of virus antigens in the biopsy specimen did allow already at an early date the diagnosis of CAH or CPH; this diagnosis could be confirmed by control biopsy and conventional microscopic examination in all these cases at a later date.