Aims: We studied the tissue expression of hepatitis B e antigen (HBeAg) in
29 liver biopsies from 27 HBV carriers. Methods: HBeAg expression was asses
sed in relation to HBeAg in serum, precore mutations, HBV DNA levels and li
ver damage as measured by histology activity index. Results: HBeAg in liver
tissue was detected by immunostaining in 6 of 7 patients positive for HBeA
g in serum. In patients negative for HBeAg in serum, HBeAg was detected in
none of II specimens from patients infected exclusively with a precore muta
nt that disrupts HBeAg synthesis, as compared with 3 of 11 specimens from p
atients carrying HBV with an intact precore region. These 3 patients all sh
owed high HBV DNA levels in serum and severe liver damage. Conclusions: Ove
rall, 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 L
oad, the pathogenetic importance of HBeAg remains unclear.