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The results of clinical, biochemical and histological studies in 26 children with chronic hepatitis B are reported. Most cases were detected when diagnostic procedures were arranged because of non specific abdominal complaints, by routing tests after acute hepatitis or multiple transfusions, and by examination of family members. Hepatomegaly was found in half of the cases, splenomegaly in a quarter. Other clinical signs were rarely seen. Among the biochemical findings, elevated serum transaminase activities were the most reliable indicators of chronic hepatitis. There was a significant difference of the mean transaminase activities between patients with CPH and CAH. In 15 children CPH was diagnosed histologically. 9 children had CAH, 2 children showed signs of MinH.

The results of immunological studies in serum and liver tissue from 26 patients with chronic HBsAgpositive hepatitis (15 CPH, 9 CAH, 2 MinH) are presented.Determination of serum immunoglobulins showed no significant differences between the three categories of HBsAg-positive CH. AGF, ANA and AMA were not demonstrable in our patients.HBsAg and anti-HBc were demonstrated in all patients, HBeAg in 16, anti-HBe in 6 patients. 2 children had anti-HBs antibodies.Elevated D N A polymerase activity was found in 8 of 12 HBeAg-seropositive and 0 of 9 HBeAg-seronegative patients.HBcAg was present in liver tissue from 9 of 10 HBeAg-seropositive and 1 of 9 HBeAg-seronegative children. In some cases the classification of viral antigen expression patterns according to the studies of Bianchi and Gudat did not correspond to the histological diagnosis and the presence of serum HBeAg.Studies in 51 family members of 23 children showed a high incidence of HBsAg carriers among the siblings and frequent evidence of anti-HBs in the mothers. Altogether, contact with HBV was demonstrated in 28 of the relatives studied.