HBeAg immunostaining of liver tissue in various stages of chronic hepatitis B

Aims: We studied the tissue expression of hepatitis B e antigen (HBeAg) in 29 liver biopsies from 27 HBV carriers. Methods: HBeAg expression was assessed in relation to HBeAg in serum, precore mutations, HBV DNA levels and liver damage as measured by histology activity index. Results: HBeAg in liver tissue was detected by immunostaining in 6 of 7 patients positive for HBeAg in serum. In patients negative for HBeAg in serum, HBeAg was detected in none of II specimens from patients infected exclusively with a precore mutant that disrupts HBeAg synthesis, as compared with 3 of 11 specimens from patients carrying HBV with an intact precore region. These 3 patients all showed high HBV DNA levels in serum and severe liver damage. Conclusions: Overall, viral replication was strongly associated with the cytoplasmic HBeAg and nuclear HBcAg staining, but not with tissue staining for HBsAg. Because of the close relationship between tissue HBeAg expression and high viral Load, the pathogenetic importance of HBeAg remains unclear.