The relationship between hepatitis B antigen, e-antigen, and liver-pathology in patients treated with dialysis

The relationship between hepatitis B antigen (HB Ag), e-antigen and liver pathology was studied in 27 patients who had died after regular dialysis treatment. The examination of the liver histology was done without knowledge of the history of the patient. Seventeen of the patients were HB Ag positive at death and had been carriers of the antigen for between 1 and 57 months. Two had chronic aggressive hepatitis and 10 chronic persistent hepatitis, but 5 had no histological signs of chronic hepatitis. e-antigen could be found in blood samples from all these patients. The cause of kidney disease, duration of dialysis and time of carriership of HB Ag showed the same variation among the patients without as among the patients with signs of chronic hepatitis. Two patients who had been HB Ag positive but were negative at death had no signs of chronic hepatitis. HB Ag positive samples available from one of these patients were also positive for e-antigen. Eight patients who were constantly negative for HB Ag were also negative for e-antigen. One of them had autopsy findings of a chronic persistent hepatitis. There were thus very moderate or even no histological signs of chronic hepatitis among these patients in spite of prolonged carriership of HB Ag. A very close correlation between HB Ag and e-antigen was also found.