吉林地区自然人群乙型肝炎病毒感染率

目的调查吉林地区自然人群乙型肝炎病毒(HBV)的感染情况及防治措施。方法采用随机抽样方法,抽取吉林地区自然人群10 298份血清,应用酶联免疫吸附试验(ELISA)进行HBV表面抗原,HBV表面抗体,HBV e抗原,HBV e抗体,HBV核心抗体检测。结果本样本中HBV感染率为11.05%(1 138例);乙型肝炎病毒HBsAg阳性为277例(2.69%),其中E抗原阳性:HBsAg+HBeAg+HBcAb阳性率为0.50%。E抗原阴性:HBsAg阳性率为0.52%;HBsAg+HBcAb阳性率为0.36%;HBsAg+HBeAb+HBcAb阳性率为1.30%;单纯HBcAb阳性率为10.55%。结论(1)吉林地区的HBV感染率,乙型肝炎表面抗原阳性,乙型肝炎核心抗体阳性分别为11.05%,2.69%,10.55%。(2)男性多于女性(1.6∶1)(P<0.01)。(3)HBV感染率随着年龄的增高而上升,为年龄组间有统计学意义(P<0.01)。     

乙肝“三对”检测的意义

检测乙肝病毒的感染状态,过去常用“两对半”,现在又称“三对”,还有“大三阳”、“小三阳”的说法,它们各有何意义? 乙肝“三对”是乙肝病毒感染机体的抗原抗体检测标志,它们由表面抗原(HBsAg)、表面抗体(HBsAb)、e抗原(HBeAg)、e抗体(HBeAb)、核心抗原(HBcAg)、核心抗体(HBcAb)等组成,在该系统里,抗原是病毒蛋白,抗体则是机体对相应抗原所产生的特异性免疫物质。HBsAg是病毒的外壳蛋白,HBeAg、HBcAg是病毒的核蛋白,HBsAb、HBeAb、HBcAb则是相应抗原产     

2014年西藏自治区1～69岁人群乙型病毒性肝炎血清流行病学特征及乙肝疫苗接种现状分析

目的:了解西藏自治区2014年1～69岁人群乙型病毒性肝炎感染现状和乙型肝炎疫苗的接种情况，评价西藏乙肝疫苗纳入儿童免疫规划工作10年来乙型肝炎控制效果。方法:采用三阶段整群随机抽样方法，在7个地级市(地区)随机抽取7 163例1～69岁常住人口，采取入户调查方式开展个案调查，并采集静脉血5 ml。所有血标本统一由中国疾病预防控制中心病毒病所采用国产酶联免疫吸附试验(ELISA)检测乙肝病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)和乙肝病毒核心抗体(抗-HBc);对于ELISA检测结果处于灰区或结果有矛盾的标本，使用美国雅培(Abbott)公司生产的AXSAM全自动检测仪及配套的微粒子酶免疫法(MEIA)检测试剂进行复核检测。结果:西藏自治区1～69岁人群HBsAg、抗-HBs、抗-HBc流行率分别为14.5%、40.99%、41.07%。1～4岁、5～14岁、15～29岁、30～69岁人群的HBsAg流行率分别为6.86%、10.07%、16.60%、16.10%,1～4岁人群HBsAg阳性率与5～14岁无统计学差异，但低于15～29岁、30～69岁人群，差异有统计学意...     

无症状HBsAg携带者免疫系统的意义

目前认为,多数无症状乙型肝炎(乙肝)表面抗原(HBsAg)携带者无严重肝损害,肝功能正常。本文综述携带者的免疫学状态。血清和肝组织中乙肝病毒标志于携带者的肝组织中检出HBsAg和乙型肝炎核心抗原(HBcAg),并发现HBsAg位于肝细胞膜、HBcAg位于肝细胞核时常有肝损害;相反,如两者位于细胞浆时则无明显肝细胞损伤,于携带者血清中可检出乙肝病毒各种标志:1.7～40%携带者血清中可检出乙型肝炎e抗原(HBeAg),11.2～98.3%可检出抗-HBe,而9.2%携带者血清中的HBeAg和抗HBe均阴性;有6.4%携     

慢性乙型肝炎肝组织内HBsAg、HBcAg的表达及临床研究进展

一直以来临床将血清乙型肝炎e抗原(HBeAg)、乙肝病毒DNA(HBV DNA)阳性作为乙肝病毒复制的标志,随着肝穿活检及抗病毒治疗的研究进展,肝活检组织中乙肝表面抗原(HBsAg)和乙肝核心抗原(HBcAg)的表达模式与血清乙型肝炎病毒(HBV)DNA定量、肝组织炎症活动度分级及纤维化分期之间关系的临床研究日益增多,本文就HBsAg和HBcAg在肝组织的表达模式及临床研究进展综述如下.     

新疆生产建设兵团人群乙肝血清学流行状况及影响因素分析

目的 了解新疆生产建设兵团（简称兵团）人群乙型病毒性肝炎（简称乙肝）的感染及疫苗接种情况,并分析影响因素,为控制当地乙肝流行提供依据。方法 采用多阶段分层随机抽样方法,于2018年抽取新疆兵团6个师的常住人口入户调查并抽取静脉血,采用酶联免疫吸附试验（ELISA）进行血清学检测,以单因素和多因素Logistic回归分析影响因素。结果 共调查2 420人,乙肝病毒表面抗原（HBsAg）阳性率、抗乙肝病毒表面抗原抗体（抗-HBs）阳性率和抗乙肝病毒核心抗原抗体（抗-HBc）阳性率分别为1.98%,67.31%,32.93%。HBsAg阳性率随年龄增加呈升高趋势（趋势χ2=16.730,P<0.05）,南疆、北疆和东疆分别为2.82%,1.36%,1.21%,差异有统计学意义（χ2=6.891,P<0.05）;抗-HBc阳性率随年龄增加呈升高趋势（趋势χ2=207.118,P<0.05）。乙肝疫苗接种率随年龄增加呈下降趋势（趋势χ2=349.918,P<0.05）,1岁～组儿童最高（99.60%）,29岁及以上组最低（57.01%）。共用牙刷、有输血史是HBsAg阳性...     

输血前4项感染性指标的结果分析及其临床意义

目的:了解患者相关感染性指标的感染情况,探讨其临床意义。方法:调阅安徽医科大学第一附属医院36 348例感染性指标检测病例,按分组要求统计乙型肝炎表面抗原(HBsAg),丙型肝炎病毒抗体(抗-HCV),人类免疫缺陷病毒抗体(抗-HIV1/2),梅毒螺旋体抗体(抗-TP)的比率。结果:36 348例患者的HBsAg,抗-HCV,抗-HIV1/2,抗-TP阳性率分别为8.47%,0.41%,0.07%,1.46%;其中5 069例门诊患者总阳性率为9.28%,31 279例住院患者总阳性率10.60%,外科组与内科组患者总阳性率分别为10.27%,11.81%;年龄<45岁组,45~59岁组和>59岁组的总阳性率分别为8.66%,13.35%,11.00%。结论:对感染性指标的检测,有利于预防医源性感染,对感染患者进行特殊护理,预防和减少患者间交叉感染。     

2006年甘肃省天祝县人群乙型肝炎监测分析

目的了解甘肃省天祝藏族自治县（天祝县）人群乙型肝炎（乙肝）病毒表面抗原（HBsAg）携带状况。方法开展全人群HBsAg携带、乙肝疫苗（HepB）接种率调查,儿童HepB接种免疫效果血清学检测。结果全人群HBsAg阳性率为3.08%;1～4岁、5～14岁儿童HBsAg阳性率分别为0.83%和2.27%;男、女HBsAg阳性率分别为3.57%和2.55%;城镇、农村HBsAg阳性率分别为1.30%和3.83%。结论天祝县1～14岁儿童HBsAg阳性率明显降低,表明自1992年将HepB纳入儿童计划免疫管理后,免疫效果显著。     

糖尿病病人乙型肝炎病毒血清标志物检测结果分析

目的研究糖尿病人乙型肝炎病毒血清标志物的含量,讨论其和感染乙肝病毒的关联性。方法选择2013年5月—2014年10月该院收治的241例糖尿病病者为观察组,选择同期来该院住院、体检等241例个体为对照组,抽取两组个体血清,按照酶联免疫吸附法检测其中乙型肝炎病毒标志物的的含量,对比两组阳性率。结果对照组乙型肝炎表面抗体阳性率74.3%,表面抗原阳性率7.9%,乙型肝炎核心抗体阳性率36.5%,与观察组的51.0%、17.0%差异有统计学意义(P0.05),而乙型肝炎e抗原阳性率0.8%和乙型肝炎e抗体阳性率25.3%,与观察组的0.9%、22.8%差异无统计学意义(P0.05)。结论糖尿病和乙型肝炎两病之间有其内在关联性。     

有偿献血员中艾滋病病毒、乙型肝炎和丙型肝炎病毒感染状况的研究

目的 探讨有偿献血员艾滋病病毒(HIV)、丙型肝炎(丙肝)病毒(HCV)、乙型肝炎(乙肝)病毒(HBV)感染的特点。方法61份HIV阳性献血员及89份HIV阴性献血员的血清,经酶联免疫吸附试验(ELISA)检测HCV抗体(抗-HCV)及HBV血清学标志物,比较两组人群的HCV、HBV及HCV/HBV感染情况。结果HIV阳性献血员的抗-HCV阳性率为70.49％。乙肝病毒表面抗原(HBsAg)与抗体(抗-HBs)、乙肝病毒e抗原(HBeAg)与抗体(抗-HBe)、乙肝病毒核心抗体(抗-HBc)和HBV的阳性率分别为8.20％、29.51％、3.28％、44.26％、11.4896、47.54％;而HIV阴性献血员的抗-HCV阳性率为19.10％,HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc、HBV的阳性率分别为2.25％、38.20％、1.12％、47.19％、6.74％、47.19％。经统计学分析,两组人群的HCV、HCV/HBV感染率的差异有显著的统计学意义,而HBV血清学标志物则无显著性差异。结论 与HIV阴性献血员相比。HIV阳性献血员的HCV感染率很高,而HBV血清学标志物则无显著性差异。对献血员进行HBV检测而未检测HIV、HCV造成的选择偏倚,可能是中国中部一些省份HIV感染者HCV感染率高而HBV感染并不相应增高这一现象的原因之一。     

Intrahepatic distribution of hepatitis B virus antigens in patients with and without hepatocellular carcinoma

AIM: To study the intrahepatic expression of hepatitis B surface antigen(HBs Ag) and hepatitis B core antigen(HBc Ag) in chronic hepatitis B patients with and without hepatocellular carcinoma. METHODS: A total of 33 chronic hepatitis B patients(mean age of 40.3 ± 2.5 years), comprising of 14 HBe Ag positive and 19 HBe Ag negative patients; and 13 patients with hepatitis B virus related hepatocellular carcinoma(mean age of 49.6 ± 4.7 years), were included in our study. Immunohistochemical staining for HBc Ag and HBs Ag was done using standard streptavidin-biotin-immunoperoxidase technique on paraffin-embedded liver biopsies. The HBc Agand HBs Ag staining distributions and patterns were described according to a modified classification system. RESULTS: Compared to the HBe Ag negative patients, the HBe Ag positive patients were younger, had higher mean HBV DNA and alanine transaminases levels. All the HBe Ag positive patients had intrahepatic HBc Ag staining; predominantly with "diffuse" distribution(79%) and "mixed cytoplasmic/nuclear " pattern(79%). In comparison, only 5% of the HBe Ag-negative patients had intrahepatic HBc Ag staining. However, the intrahepatic HBs Ag staining has wider distribution among the HBe Ag negative patients, namely; majority of the HBe Ag negative cases had "patchy" HBs Ag distribution compared to "rare" distribution among the HBe Ag positive cases. All but one patient with HCC were HBe Ag negative with either undetectable HBV DNA or very low level of viremia. Intrahepatic HBc Ag and HBs Ag were seen in 13(100%) and 10(77%) of the HCC patients respectively. Interestingly, among the 9 HCC patients on anti-viral therapy with suppressed HBV DNA, HBc Ag and HBs Ag were detected in tumor tissues but not the adjacent liver in 4(44%) and 1(11%) patient respectively. CONCLUSION: Isolated intrahepatic HBc Ag and HBs Ag can be present in tumors of patients with suppressed HBV DNA on antiviral therapy; that may predispose them to cancer development.     

Serological survey on hepatitis A and B infections among the residents of social welfare homes in Singapore

A study of the immunological status of hepatitis A and B infections was carried out among the residents of eight social welfare homes in Singapore. The sample population consisted of 440 individuals of whom 55% were Chinese, 21% were Malays and 24% were Indians. The mean age of the study population was 14 years and 4 months. The immunological markers studied included specific IgM antibody and total antibody against hepatitis A virus (anti-HAV-IgM and total anti-HAV respectively); hepatitis B surface antigen (HBsAg), surface antibody (anti-HBs), core antibody (anti-HBc) and e antigen (HBeAg), all tested by the enzyme immunoassay (EIA) technique.
While none of the subjects had detectable anti-HAV-IgM (HAVAB-M-EIA), 12% were positive for total anti-HAV (HAVAB-EIA) indicating evidence of past infection. HBsAg was detected (Auszyme II) in 4.5% and of these, half had HBeAg (Abbott-HBe EIA). Anti-HBs positivity (AUSAB-EIA) occurred in 11.6% and the majority (88%) of these had anti-HBc positivity (CORZYME) as well. The positive rate for anti-HBc alone was 3.6% reflecting the 'window' period after the fall of HBsAg and before the rise of anti-HBs. At least one of the hepatitis B markers was present in 19.1% of the study population.
The endemic nature of both hepatitis A and B infections in the local population is evident, with infection occurring in all ethnic groups at an early age.     

Hepatitis D virus (delta agent) superinfection in an endemic area of hepatitis B infection: immunopathologic and serologic findings

In 86 Chinese patients with histologically proven hepatitis B surface antigen (HBsAg) positive chronic hepatitis and serum alanine aminotransferase levels exceeding 200 U/l, antibody to hepatitis D antigen (HDAg) was detected more frequently in sera from hepatitis B e antigen (HBeAg) negative patients (11/35, 31.4%) than in HBeAg positive (4/51, 7.8%) patients (p less than 0.02). 10 liver biopsy specimens (76.9%) from 13 chronic hepatitis B patients with superimposed hepatitis D virus (HDV) infection, showed positive staining for HDAg in their hepatocytes. Neither HBsAg nor hepatitis B core antigen (HBcAg) was found in the liver in 12/13 patients with superimposed HDV infection. However, in liver biopsy specimens from 42 patients without HDV superinfection, HBsAg was stained positively in 41 patients (97.6%), and HBcAg in 24 patients (47.1%). Using dot blot hybridization technique, serum hepatitis B virus (HBV) DNA was detected in 62.1% (41/66) of patients without HDV superinfection, while it was detected only in 10.0% (1/10) of patients who had HDV superinfection. It is concluded that HDV superinfection plays a significant role in Taiwan in HBeAg negative chronic hepatitis B patients with clinical "exacerbation". The data show clear evidence of HDV interfering with the replication of HBV.     

Hepatitis B virus markers in the population of Dar es Salaam, Tanzania

A total of 542 serum samples from healthy adults (medical students and medical staff, blood donors and pregnant women) residing in or near the city of Dar es Salaam, Tanzania were examined for markers of hepatitis B virus (HBV) infection. Of these samples, 95 (17.5%) were not found to contain any HBV marker when examined by enzyme-linked immunoassay for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc). HBsAg was demonstrated in 52 (9.6%) samples of which 7 (13.5%) were positive for hepatitis Be antigen (HBeAg) and 17 (32.7%) were positive for anti-HBc IgM. None of 9 HBsAg positive pregnant women were carriers of HBeAg. These results show that hepatitis B infection is very common in this country. The relatively low prevalence of HBeAg among HBsAg carriers may indicate that transmission of hepatitis B at birth is not of major importance.     

Biologic and prognostic significance of hepatocyte hepatitis B core antigen expressions in the natural course of chronic hepatitis B virus infection

To elucidate the biologic significance of hepatocyte hepatitis B core antigen (HBcAg) expression and its relation to the natural course of hepatitis B virus (HBV) infection, the patterns of HBcAg were correlated with HBV virus replication state and the disease activity in 598 needle liver biopsies performed on 569 hepatitis B surface antigen (HBsAg) carriers aged 1-81 years. A good correlation of liver HBcAg with serum HBeAg and HBV DNA status was demonstrated. HBcAg was present in the hepatocyte nuclei (nHBcAg) or cytoplasm (cHBcAg), or in both (mixed). Pure nHBcAg was seen mainly in children and young adults; 86% of the patients had non-aggressive disease, but rare cases of chronic active hepatitis (CAH) and HBeAg seroconversion were observed. In contrast, cHBcAg was predominantly associated with CAH (52%) and accompanied by a significantly higher HBeAg seroconversion rate (27%). The HBeAg-negative group, particularly the liver HBcAg-negative subgroup, had a lower frequency of CAH, but an increased incidence of non-aggressive disease as well as cirrhosis and/or hepatocellular carcinoma, indicating that HBeAg seroconversion to anti-HBe does not necessarily mean a favorable prognosis. The results suggest that expression of HBcAg correlates with the liver pathology and the three phases of chronic HBV infection: (1) the early immune tolerance phase is characterized by nHBcAg, mild disease and low HBeAg seroconversion rate; (2) the virus replication/elimination phase by cHBcAg or negative HBcAg, frequent CAH, and high HBeAg seroconversion rate; and (3) the inactive virus replication phase by negative HBcAg and a bipolar disease spectrum.     

Prevalence of IgM anti-HBc among HBsAg carriers in Okinawa, Japan

To evaluate the presence of IgM antibody to hepatitis B core antigen (IgM anti-HBc) in hepatitis B surface antigen (HBsAg) carriers, serial serum specimens of 698 carriers in Okinawa, Japan, from infants to adults, were studied by radioimmunoassay. IgM anti-HBc was detected in 7.6% of these carriers, with no difference between the sexes. The prevalence of IgM anti-HBc was higher in the age groups 0-9, 50-59 and over 60 than in the age group 20-29 and 30-39 years. In hepatitis B e antigen (HBeAg) positive carriers, the prevalence of IgM anti-HBc was 15.4%, a value significantly higher than in the HBeAg-negative carriers at 6.6%. In carriers with liver damage, the prevalence of IgM anti-HBc was 33.3%, a level significantly higher than the 6.3% in carriers without liver damage. However, IgM anti-HBc was detected in 34 carriers with neither HBeAg nor liver damage. These carriers are being closely followed. We discussed the presence of IgM anti-HBc in association with HBeAg or liver damage. The presence of IgM anti-HBc among HBsAg carriers was closely associated with liver damage.     

Seroprevalence of Hepatitis B and C among Children in Endemic Areas of Turkey

Background and Aims

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are major worldwide public health problems. The objectives of this study were to evaluate the seroprevalence and epidemiological profile of hepatitis B and hepatitis C, to determine the impact of the national vaccination programme against hepatitis B on the prevalence of the hepatitis B surface antigen (HBsAg) carrier and the antibody to hepatitis B surface antigen (anti-HBs) occurrence rate among 0-14 year-old children in southeast Turkey.

Methods

The seroprevalence of hepatitis B and hepatitis C markers was evaluated retrospectively in a group of 10,391 children who were admitted to a tertiary hospital, the Diyarbakir Education and Research Hospital, from January 2005 to December 2008, in order to obtain a better understanding of the regional hepatitis seroprevalence. Children were divided into three different age groups: pre-education period (0-6 years), primary school period (7-12 years) and secondary school period (13-14 years). Samples were analyzed for HBsAg, hepatitis B e antigen (HBeAg), antibody to HBeAg (anti-HBe), anti-HBs positive/antibodies to hepatitis B core antigen (anti-HBc) positive, isolated anti-HBs and antibodies to Hepatitis C virus (anti-HCV) using a commercially available enzyme-linked immunosorbent assay (ELISA).

Results

The mean age of all participants was 8.5± 2 years (range, 0-14). The overall percentages for the prevalence of HBsAg, HBeAg, anti-HBe and anti-HCV were 8.1%, 2.1%, 5.9% and 0.5%, respectively. HBsAg seroprevalence differed significantly by age and gender (P < 0.001). HBeAg seroprevalence was high in the earliest years (P < 0.01). The overall prevalence of anti-HCV did not differ significantly by age (P > 0.5) but differed by gender (P < 0.001). The overall percentages for the prevalence of isolated anti-HBs and anti-HBs positive/anti-HBc positive were 34.2% and 56.9%,respectively.

Conclusions

Our study sheds new light on hepatitis seroprevalence in southeastern Turkey. For example, 1) The seroprevalence of hepatitis B in southeast Turkey is still at its highest rate, according to the averages reported in other studies conducted in the same and different regions of Turkey; and it has not decreased, as reported previously. 2) HBeAg seroprevalence in the earliest years of childhood is high in our study; this is evidence for early acquisition of the infection.3) Isolated anti-HBs positive and anti-HBs positive/anti-HBc positive prevalence is high; given these features, it is obvious that despite the high incidence of vaccinated children, the prevalence of hepatitis B is increasing; and children acquire these viruses in their earliest years. 4) We found the overall prevalence of HCV infection unchanged. Our region has a low endemicity for HCV.     

A longitudinal follow-up of asymptomatic hepatitis B surface antigen-positive Chinese children

Fifty-one asymptomatic Chinese hepatitis B surface antigen (HBsAg) carrier children (34 boys, 17 girls), age 1 to 15 years (median: 10 years), were prospectively followed for up to 4 years (median: 30 months) to determine the natural evolution of clinical, biochemical and virological features during the early phase of chronic hepatitis B virus infection. Hepatomegaly was the only abnormal finding on examination, being present in five children initially and four at follow-up. Serum ALT levels were normal in 80% of the children at presentation and remained within the normal range during the study in 60%. Fluctuations in ALT levels were mild. In four of 12 instances, transient elevations in ALT levels were associated with a fall in serum hepatitis B virus DNA levels. At presentation, 43 (84%) children were hepatitis B e antigen (HBeAg) positive; only two (7%) cleared HBeAg on follow-up. None of the eight children who were initially positive for the antibody to HBeAg reverted back to HBeAg positivity. All the children remained HBsAg positive. In this study, we demonstrated that chronic hepatitis B virus infection in asymptomatic Chinese children is usually associated with a mild and stable liver disease despite high levels of hepatitis B virus replication. This may reflect an immunological tolerance to the hepatitis B virus induced by early exposure to the virus and accounts for the persistently high levels of hepatitis B virus replication on follow-up.     

Serological assessment of HBcAg and HBV DNA: its prognostic relevance in acute hepatitis B

Treatment of serum precipitates with sodium thiocyanate in patients with hepatitis B virus (HBV) replication results in liberation of circulating hepatitis core antigen (HBcAg) which can be demonstrated radioimmunologically. Follow-up investigations were performed in 80 patients with acute hepatitis B. Sera were examined for HBcAg. HBV DNA and conventional HBV markers. At the time of admission to hospital 34 of 80 (42%) patients were HBeAg positive. Twenty-six (76%) of the 34 HBcAg positive patients were HBV DNA positive, and circulating HBcAg was detectable in 25 of 34 (73%) HBcAg positive cases. In patients with uncomplicated courses of acute hepatitis B the serological HBcAg assay and HBV DNA became negative 1 to 8 weeks before elimination of HBeAg and up to 12 weeks earlier than the sera became negative for HBsAg. Five patients (6%) showed transition to chronic hepatitis B with persistence of HBsAg, HBeAg, HBV DNA and HBcAg in serum. One patient with acute hepatitis B and development of chronic hepatitis suffered from acquired immunodeficiency syndrome and showed delayed formation of anti-HBc. In this case uncomplexed HBcAg was demonstrable during the acute phase of hepatitis B. With the appearance of anti-HBc HBcAg circulated in a complexed form. The data indicate that serological determinations of HBcAg and HBV DNA can serve as prognostic markers in the early phase of acute hepatitis B. The demonstration of uncomplexed HBcAg in serum of a patient with inadequate formation of anti-HBc supports the hypothesis that circulating HBcAg is usually complexed by specific antibodies.     

Intrahepatic distribution of hepatitis B surface and core antigens in chronic hepatitis B virus infection. Hepatocyte with cytoplasmic/membranous hepatitis B core antigen as a possible target for immune hepatocytolysis

The intrahepatic distribution of hepatitis B core antigen (HBcAg) and surface antigen (HBsAg) was studied in 32 patients with chronic type B hepatitis, and the results were correlated with the status of hepatitis B e antigen/antibody (HBeAg/anti-HBe) and with the histologic activity of the patients. In HBeAg-positive patients with minor hepatitis activity, HBcAg was distributed mainly in the nuclei, whereas HBsAg was diffusely located on the plasma membrane as well as focally in the cytoplasm. In HBeAg-positive patients with chronic active liver disease, although the distribution pattern of HBsAg in liver remained unchanged, the expression of nuclear HBcAg decreased significantly with concomitant increase in cytoplasmic/membranous HBcAg expression. In HBsAg carriers who were anti-HBe positive, HBcAg was undetectable anywhere, whereas HBsAg could be seen only in the cytoplasm. These results suggest that membranous expression of HBsAg relates closely to active viral replication but is probably not responsible for the observed histologic activities. In contrast, cytoplasmic/membranous expression of HBcAg correlates with high degree of liver inflammatory activity. It is therefore suggested that hepatocytes with cytoplasmic/membranous HBcAg expression might be the target cells for immune hepatocytolysis.