Summary
The histopathology of the liver and the detectability of intrahepatic hepatitis B virus (HBV) markers were studied in 34 autopsy cases in elderly patients (mean age 73.9 years, range 60–91 years) who had had a history of positive HBV surface antigenaemia prior to death. Seven of 14 persistent HBV carrier cases (group A) in which long-lasting HBV surface antigen (HBsAg) carriage in the sera had been confirmed by sequential assays, and 5 out of 15 HBV-infected people (group C, single assay) showed significant primary liver damages including chronic hepatitis, toxic hepatitis, liver cirrhosis and hepatocellular carcinoma. In 5 cases (group B), one of which was type B liver cirrhosis, HBsAg became negative and HBsAb appeared during the follow-up period (up to 33 months). Among confirmed HBV carriers, HBsAg and HBV core antigen were most frequently found in the liver of cirrhotic cases with and without hepatocellular carcinoma (5 of 6), whereas these were rarely detected in those with nonspecific changes or slight hepatitic activity (1 of 7). All 5 cases in group B were negative for histological HBV-related antigens and the findings in group C were variously interpreted. Post-mortem cases of the aged HBV carriers who survived their mean life expectancy represent an important population in which to study the natural history of HBV carriers.
Similar content being viewed by others
References
Beasley RP, Hwang LY, Lin CH-CH, Chien C-S (1981) Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22707 men in Taiwan. Lancet II: 1129–1133
Feinman SV, Berris B, Cooter N, Sinclair JC, Wrobel DM (1982) The results of a long term prospective study of hepatitis B surface antigen (HBsAg) carrier state. Hepatogastroenterology 29:58–61
Hoofnagel JH, Shafritz DA, Popper H (1987) Chronic type B hepatitis and healthy HBsAg carrier state. Hepatology 7:758–763
Lijima T, Saitoh N, Nobutomo K, Nambu M, Sakuma K (1984) A prospective cohort study of hepatitis B surface antigen carrier state. Hepatogastroenterology 29:58–61
James V, Nuttall PA (1984) Reduction in numbers of HBsAg positive donors. BMJ 289:1424
Mori W, Machinami R, Tanaka K (1980) Pathology of hepatocellular carcinoma. Pathol Res Pract 169:4–20
Ray MB, Desmet VJ, Fevery J, De Groote J, Bradburne AF, Desmyter J (1976) Distribution pattern of hepatitis B surface antigen (HBsAg) in the liver of hepatitis patients. J Clin Pathol 29:94–100
Reinicke V, Dybkiaen E, Poulson H, Banke O, Lylloff K, Nordenfelt E (1972) A study of Australia antigen positive blood donors and their recipients, with special reference to liver histology. N Engl J Med 286:867–870
Sakuma K, Takahara T, Tsuda F, Mayumi M (1982) Prognosis of hepatitis B virus surface antigen carriers in relation to the routine liver function tests: a prospective study. Gastroenterology 83:114–117
Sakurai M, Nakaso S (1982) Distribution of HBs antigen in livers revealed by orcein staining. Hepatogastroenterology 29:9–12
Shikata T, Uzawa T, Yoshikawa N, Akatsuka T, Yamazaki S (1974) Staining methods of Australian antigen in paraffin sections. Jpn J Exp Med 44:25–36
Simon JB, Patel S (1974) Liver disease in asymptomatic carriers of hepatitis B antigen. Gastroenterology 66:1020–1028
Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare (1986) Vital Statistics of Japan
Suzuki K, Uchida T, Horiuchi R, Shikata T (1985) Localization of hepatitis B surface and core antigens in human hepatocellular carcinoma by immunoperoxidase methods. Replication of complete virus in carcinoma cells. Cancer 56:321–327
Tamura I, Kurimura O, Inaba Y (1986) A follow up study of hepatitis B virus carriers at hospital. Jpn J Cancer Res 77:992–997
Tanaka K, Mori W, Suwa K (1981) Victoria blue-nuclear fast red stain for HBs antigen in paraffin section. Acta Pathol Jpn 31:93–98
Vittal SB, Dourdourekas D, Shobassy N, Gerber M, Telischi M, Szanto PB, Steogmann F, Clowdus BF (1974) Asymptomatic hepatic disease in blood donors with hepatitis B antigenemia. Am J Clin Pathol 62:649–654
Wu T-S, Hsu H-C, Chen D-S, Sheu J-C, Su I-J, Chen S-L, Chuang S-M (1987) Clearance of hepatitis B surface antigen (HBsAg) after surgical resection of hepatocellular carcinoma. J Hepatol 4:45–51
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sugimura, H., Fukazawa, T., Saitoh, M. et al. The histopathology of the liver in older patients with hepatitis B virus surface antigenaemia. Vichows Archiv A Pathol Anat 419, 409–415 (1991). https://doi.org/10.1007/BF01605075
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01605075