Serial liver biopsy observations in hepatitis B antigen carriers by light and electron microscopy

Liver morphology and function were restudied after an interval of 1 1/2-2 years in 21 Chinese men with hepatitis B antigen (HBsAg). Antigenemia and mild liver histopathology disappeared in one individual who developed antibody to HBsAg(Anti-HBsAg). 20 subjects who were chronic carriers of HBsAg had mild histological abnormalities which were usually persistent and were more commonly lobular than portal. Particularly striking were focal necrosis, eosinophilic bodies, ground-glass cytoplasmic change, and, by electron microscopy, microtubular structures within cytoplasmic membranous cysternae. Interval development of chronic aggressive hepatitis was observed in only one subject. This study suggests that the great majority of HBsAg carriers have a good prognosis at least over a 1 1/2-2-year period, and that liver biopsy is most indicated in those with persistent liver function abnormalities.