Evaluation of the various procedures for the demonstration of hepatitis B surface antigen and hepatitis B core antigen in liver tissue

Abstract

There exists a proven link between HBsAg and serum hepatitis or hepatitis B. However, contact with HBV produces diverse reactions in the host (Dudley et al., 1971; Hoofnagle et al., 1975). HBsAg may remain undetectable in the serum even by as sensitive a technique as radioimmunoassay in a significant number of patients with clinical hepatitis even when longitudinal studies and the evolution of HB antibodies suggests HBV as the causative agent (Hoofnagle et al., 1975). Sometimes HBsAg could not be detected in the liver of hepatitis B patients despite the presence of the antigen in the body fluids (Krawczynski et al., 1972). On the contrary the absence of the antigen in the serum does not exclude its presence in the liver (Ray et al., 1976a; Ray et al., 1976b). Although these discrepancies in the findings may be due to varying degrees of interactions between the host immune system and the virus (Blumberg et al., 1970; Dudley et al., 1971), serum HBsAg may be masked by components of normal serum proteins such as complement factors (Miller et al., 1972) and certainly by anti-HBs itself (Shorey and Combes, 1973) and thus may remain undetectable by immunological methods. This study was undertaken to improve the demonstration of HBsAg in liver tissue and was achieved by adding a tissue heating step to the conventional fluorescence antibody technique.