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The authors report a prospective study of 34 chronic HBs Ag carriers detected among a cohort of 9029 blood donors. Liver biopsy performed in all cases revealed a normal liver in 5 cases (14.7%), non-specific lesions in the form of fatty infiltration or mild portal inflammation in 3 cases (8.8%), chronic persistent hepatitis (CPH) in 21 cases (61.7%) (mild in 19 and moderate in 2) and chronic active hepatitis (CAH) in 5 cases (14.6%) (mild in 1 and moderate in 4). Liver function tests were abnormal in 28.8% of patients with CPH and 20% of those with CAH. Histologic activity index was calculated and was more than 6 in 40% of CAH and 6 or less in CPH and non-specific lesions. Immunohistochemical study revealed cytoplasmic labelling for HBs Ag in 82.4 per cent of cases and nuclear labelling for HBc Ag in 11.4% of cases with a heterogeneous and non-regular pattern affecting all or part of the cytoplasm, single or clusters of hepatocytes or even sheets of hepatocytes.

Liver biopsies of sixty patients with different forms of hepatitis and ten control subjects without hepatic disorders were examined by means of direct immunofluorescent methods for the HBsAg, immunoglobulins, fibrin and C3. The presence of fluorescent particles of HBsAg in the cytoplasm of hepatocytes were correlated with the presence of HBsAg in the serum. The fluorescence did not seem specific of histological stage of hepatitis. Immunoglobulins and fibrin were often demonstrated in hepatic sinusoids, especially in chronic aggressive hepatitis. In contrast, C3 is rarely observed.