Complement fixing hepatitis B core antigen immune complexes in the liver of patients with HBs antigen positive chronic disease

Abstract

152 biopsies from serologically HB(s)AG positive and negative patients with liver disease were studied in immunofluorescence for the presence of the surface (HB(s)) and the core (HB(c)) antigenic determinants of the hepatitis B virus, of immunoglobulins and complement (C) deposits, and for the capacity to fix human C. Circumstantial evidence is presented suggesting that HB(c) immune complexes are a relevant feature in the establishment and progression of chronic HB(s)Ag liver disease. C fixation by liver cells was shown in all HB(c) positive patients with chronic hepatitis; an active form was present in every case, except 2 with a persistent hepatitis, an inverse ratio of HB(c) to C binding fluorescence being noted between active hepatitis and cirrhotic patients. HB(c) without C fixation was observed in only 3 patients in the incubation phase of infectious hepatitis. IgG deposits were often found in HB(c) containing, C fixing nuclei. No C binding or IgG deposits were observed in acute self limited type B hepatitis, in serologically positive patients with normal liver or minimal histological lesions, with and without HB(s) cytoplasmic fluorescence in their biopsy, or in serologically negative individuals.