Occurrence of hepatitis B-surface antigen in a consecutive material of 1539 liver biopsies

The frequency and occurrence of hepatitis B-surface antigen (HBsAg) in 1539 consecutive liver biopsies were determined using orcein staining as screening method. In HBsAg seropositive cases sections were in addition stained with immunoperoxidase staining for HBsAg in order to reassure the presence of HBsAg in liver cells. HBsAg was demonstrated in 36 biopsies (2.3%). The highest frequency was found in biopsies with chronic hepatitis (28%). In biopsies with slight non-specific changes 10% and in cirrhotic 4.5% contained HBsAg. HBsAg was not detected in biopsies with acute hepatitis. No correlation was found between the number of HBsAg containing cells in the biopsies and the histological/biochemical activity in the liver. It is concluded that orcein staining of ground-glass appearance is a highly specific HBsAg marker. The sensitivity is about 80% in cases with minimal changes, chronic hepatitis and cirrhosis. The method is unsuitable as etiological marker in cases with acute hepatitis.