A cross sectional study of markers of hepatitis B infection in Niue

To determine whether the island of Niue would be a suitable location to evaluate the efficacy of hepatitis B vaccine, the prevalence of hepatitis B infection in the adult population was studied. Sera were collected from 1147 of 1244 residents above the age of 20 years, and tested for the presence of hepatitis B surface antigen (HBsAg) and specific antibody to the surface and core antigens (anti-HBs and anti-HBc) by solid-phase radioimmunoassay (SPRIA). Hepatitis B was found to be hyperendemic; 11.9% of those tested were found to be carriers of HBsAg and an additional 84% had detectable levels of anti-HBs or anti-HBc indicative of current or past infection. In this population HBV infection appears to occur early in life as the peak prevalence of serological markers was found in young adults. The almost universal infection of the population, their high rate of compliance with the study and the relatively high birth rate indicate that Niue would be a suitable location to evaluate methods of preventing hepatitis B infection.

Characterization of a precipitating antigen detected in the serum of patients with viral hepatitis

During a search for the aetiological agent of non-A non-B hepatitis, a precipitating antigen was detected in the sera of some patients during the acute phase of their illness. The antigen was detected by agar gel diffusion using antibody from convalescent sera obtained from patients with non-A non-B hepatitis, and from haemophiliac sera. The antigen was usually detected early in the patient's illness, disappearing as liver function tests returned to normal. In some patients specific antibody appeared during the convalescent phase of the disease. The antigen does not appear to be specific for non-A non-B hepatitis, as it could be detected with similar frequency in patients with hepatitis A or hepatitis B and some patients with other liver disorders. Biochemical and biophysical studies suggest that the antigen is probably an abnormal lipoprotein produced as a result of acute liver damage.

Seroepidemiology of infection with hepatitis B virus in Fiji

A batch of 984 sera obtained from a stratified sample of Melanesians and Indians living in rural and urban areas of Fiji in 1981 were for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc) by solid phase radioimmunoassay. The prevalence of hepatitis B infection (as measured by the sum of HBsAg and anti-HBc frequencies of HBsAg negative sera in the two groups) was 81.5% and 17.9%, respectively. No major differences were detected between urban and rural populations. While hepatitis B virus is endemic in Melanesians and Indians, the epidemiology of the infection shows certain differences. Among Melanesians, infection appears to be acquired early in life and peak prevalence of serologic markers of infection occurs during the second decade. Among the Indian population, the prevalence of markers increases steadily with age, presumably as a result of continuous exposure and infection throughout life. the high prevalence of infection and carriers among Melanesians is consistent with previous observations among Pacific populations. The lower prevalence of infection among Indians is remarkable, since they constitute almost half of the total population and live under similar conditions. Since the two populations remain largely separate in terms of housing and schooling, and intermarriage is uncommon, it is no possible to determine whether these differences merely represent different degrees of exposure to the virus or are the reflection of differences in susceptibility or response to infection.

Serum immunoglobulin levels in acute A, B, and non-A, non-B hepatitis

Immunoglobulin M, G, and A concentrations were determined by radial immunodiffusion in sera collected from 117 patients with acute hepatitis A, hepatitis B, or non-A, non-B hepatitis. Statistically significant differences in IgG and IgM levels were detected between the three groups. In particular, elevated IgG and almost-normal IgM levels were regularly detected in patients with non-A, non-B hepatitis while the opposite pattern was seen in patients with hepatitis A. Calculation of a serum IgG/IgM ratio enabled discrimination between most patients with non-B hepatitis. In 92% of patients with hepatitis A, the ratio was less than 6, whereas 82% of patients with non-A, non-B hepatitis had ratios of greater than 6. The IgG/IgM ratio may be of value in distinguishing between subjects with the two forms of the disease when specific serologic tests are unavailable.

Detection of markers of hepatitis B infection in serum dried on to filter-paper: an application to field studies

In an attempt to find a cheap, reliable, and convenient method for the transportation and storage of serum specimens during seroepidemiological surveys, a technique in which serum was dried on to pieces of filter paper was developed and evaluated. For the evaluation, a total of 382 sera were selected from the extensive serum collection held by the WHO Collaborating Centre for Virus Reference and Research at Fairfield Hospital, Australia. These sera were dried on to pieces of filter-paper, stored at different temperatures and then tested for the presence of the various markers of infection with hepatitis B virus by solid-phase radioimmunoassay. The results were in complete agreement with those obtained on whole serum specimens. In addition, storage at 4 degrees C, room temperature (22 degrees C), or 37 degrees C for up to 30 days did not alter the sensitivity of the test. This technique may be useful in field surveys, not only for the detection of hepatitis B infection, but also in the study of other diseases and metabolic disorders.