Biological interpretation of baseline hepatitis B surface antigen and cirrhosis in determining interferon treatment duration

Figure 1 Laennec cirrhosis substaging (4A-4C) and sinusoidal remodeling illustrate structural changes potentially relevant to immune surveillance and interferon bio-distribution in chronic hepatitis B. A-C: Representative Masson trichrome-stained liver sections demonstrating progressive architectural distortion across Laennec cirrhosis substages (collagen in blue; hepatocytes in pink/red). Laennec 4A: Mild cirrhosis with relatively thin septa and early nodular remodeling (A). Laennec 4B: Moderate cirrhosis with broader septa and more evident nodule formation (B). Laennec 4C: Severe cirrhosis with thick, widely distributed septa and pronounced regenerative nodules, reflecting advanced compartmentalization of the parenchyma (C); D: CD34 immunohistochemistry showing sinusoidal endothelial cell capillarization (CD34-positive sinusoidal staining; brown), consistent with cirrhosis-associated vascular remodeling. Arrows denote a regenerative nodule; E: Conceptual schematic contrasting the healthy sinusoid - with fenestrated liver sinusoidal endothelial cells facilitating solute transfer and immunosurveillance - vs the cirrhotic sinusoid, where capillarization/defenestration with basement membrane deposition creates a physical and functional barrier that may limit interferon penetration and immune effector cell access to infected hepatocytes. The pathology images were captured by Zou LF; The schematic in panel E was created by Wang CL using BioRender. Scale bars = 100 μm. LSECs: Liver sinusoidal endothelial cells; BM: Basement membrane.