Immune Complexes in Hepatocytic Nuclei of Hb Ag-Positive Chronic Hepatitis

Abstract

To localize immune complexes in viral hepatitis Type B and to assess their pathogenic role, we examined by the direct fluorescent-antibody technic 21 liver specimens with hepatitis B core antigen (HB_c Ag) in hepatocytic nuclei from 10 patients with HB_s Ag-seropositive acute viral hepatitis and from 11 patients with HB_s Ag-seropositive chronic active hepatitis. IgG with in vitro fixation of complement was demonstrated in HB_c Ag-containing hepatocytic nuclei of all patients with chronic active, but not in those with acute viral hepatitis. All patients except for one had antibody to HB_c Ag in the serum as determined by indirect immunofluorescence. The evidence suggests that intranuclear IgG in chronic active hepatitis has anti-HB_c specificity and forms immune complexes with HB_c Ag. The binding of IgG to intranuclear HB_c Ag might have pathogenic importance in chronic active hepatitis. (N Engl J Med 294:922–925, 1976)