Hepatitis B Surface Antigen (HBsAG)

Sources/Clones
Accurate (BM51), American Research Products (03A3403), American Research Products/EY Labs, Axcel/Accurate (polyclonal), Becton Dickinson, Biogenesis (1044-329, polyclonal), Biogenex (SI201), Calbiochem, Dako (polyclonal, 3E7), Fitzgerald (M94172, M94173, M94253, M94254, polyclonal), Harlan Seralab/Accurate (V2.5G4, V2.6E4), Novocastra (1044/341), Pharmingen (S1-210) and Zymed (ZCH16, ZMHB5).

Fixation/Preparation
These antibodies are applicable to formalin-fixed, paraffin embedded tissues. No antigen unmasking is required. However, caution is advised when using the ABC immunodetection method, as liver cells contain biotin and may cross react with the ABC system.

Background
The complete hepatitis B virus (Dane particle) is a 42 nm double-stranded DNA virus (Hepadna virus), composed of a 27 nm core particle and envelope, 7 nm in thickness, and immunolocalized within the endoplasmic reticulum of liver cells. The glycosylated surface protein of hepatitis B (HB) virus is composed of three gene products: the small, middle and large HBs protein, governed by the S, pre S2 and pre S1 domains respectively (Gudat & Bianchi, 1977).

Applications
These antibodies react with antigen-positive cells in patients with type B viral hepatitis, cirrhosis and hepatocellular carcinoma. Immunoreaction may occur in seropositive as well as seronegative patients. HBsAg in human liver biopsies has two expression patterns with apparently different biological implications. Membranous HBsAg is strongly associated with HBc expression and is an indirect indication of replicative HBV infection.
IntracytoplasmicHBsAg in excess is visible by H&E staining as a homogeneous ground-glass appearance of the cytoplasm (Hadziyannis et al, 1973), and is an indicator of chronic elimination insufficiency for this antigen but is an unreliable marker of active replication. In contrast, membrane-associated HBsAg should always raise suspicion of active viral replication.

Comments
Liver tissue from known patients with hepatitis may be used as control tissue for both HbcAg and HbsAg.

References
•Gudat F, Bianchi L 1977. HGsAg: a target antigen on the liver cell? In: Popper H, Bianchi L, Reutter W, eds. Membrane alterations as basis of liver injury. Lancaster: MTP Press, 171-178.

•Hadziyannis S, Gerber MA, Vissoulis C, Popper H 1973. Cytoplasmic hepatitis B antigen in "ground glass" hepatocytes of carriers. Archives of Pathology 96: 327-330.

Bibliografía
Manual of diagnostic antibodies for immunohistology / Anthony S.-Y. Leong, Kumarasen Cooper, F. Joel W.-M. Leong.