[Morphologic findings in liver tissue in chronic active hepatitis B after seroconversion from HBeAg to anti-HBe]

Replication of the virus is in the majority of patients with chronic hepatitis B associated with permanent activity and progression of the inflammatory process. The change of the virus to the latent stage expressed by seroconversion of HBeAg to anti-HBe leads to a significant repression of inflammatory changes and has a favourable impact on the course of the disease. The morphological changes in the hepatic tissue after spontaneous seroconversion or after interferon treatment were investigated in specimens of needle biopsy in 18 patients with active chronic hepatitis B. In 10 of them the diagnosis of chronic hepatitis was confirmed by biopsy in the stage of replication of the virus. During the subsequent time interval after seroconversion of HBeAg, incl. two instances where interferon was administered, in the tissue of 14 HBsAg positive patients regression of inflammatory changes was apparent, in particular a lower incidence of piecemeal necroses. The regular finding of periportal and septal fibrosis in these patients is probably associated with a longer course of chronic active hepatitis and late spontaneous or therapeutically induced seroconversion of HBeAg. In one man, treated with interferon, morphological examination revealed one month after seroconversion of HBeAg an acute exacerbation of the disease. In another three patients, who at the time of the bioptic examination were HBsAg negative, in the hepatic tissue minor silent periportal and septal fibrosis persisted.