The clinical and histopathologic characteristics in HBsAg-negative chronic hepatitis B

Objective To assess the clinical and histopathologic characteristics of HBsAg-negative chronic HBV infection.Methods Thirty-one patients with chronic hepatitis of unknown aetiology were enrolled in the study.Serum HBVDNA of all the cases was analyzed by PCR.Liver specimens were examined by immunohistochemistry for HBsAg,HBcAg.The pathological changes were classified into 4 grades and 4 stages.Results Liver biopsies and clinical characteristics from these patients showed chronic hepatitis B in 11 cases,liver cirrhosis 7 cases.Of the 18 patients were examined by immunohistochemistry,two were positive for HBsAg,16 for HBcAg.Their histological changes were more advanced.7 cases of G4 and S4;11 cases of G1-3 and S2-3.Conclusion Occult HBV infections may account for a high proportion of the cases with chronic hepatitis of unknown etiology.Low serum level of HBV may cause disease progression.The clinical significance of this kind of patients should not be underestimated.It may be the cause of some cases of cryptogenic cirrhosis and hepatocellular carcinoma of unknown etiology.