Persistent HB antigenemia: associated clinical manifestations and hepatic lesions

The clinical, biochemical and histological features in nine asymptomatic HBs Ag carriers, 15 patients with symptomatic HBs Ag-positive chronic active hepatitis (CAH), and 29 patients with HBs antigenemia persistent for five months or longer following a documented attack of acute viral hepatitis were compared, and contrasted with those in 67 patients with HBs Ag-negative CAH. The findings were remarkably similar in all groups. However, young males predominated in all three HBs Ag-positive groups, whereas most HBs Ag-negative cases of CAH were in middle-aged women. Moreover, in the latter group, the lesions tended to be more extensive and more commonly were accompanied by smooth muscle antibody, antinuclear antibody and LE cells, and extrahepatic manifestations, such as ulcerative colitis, arthritis, pleurisy and pericarditis.