THE SURVEILLANCE OF TRANSFUSION-ASSOCIATED VIRAL HEPATITIS

Study of the immunogenicity and infectivity of hepatitis B-containing stabilized plasma-protein solution

In early 1984, five patients who were undergoing plasmapheresis at a Melbourne hospital developed a transient hepatitis B surface antigenaemia. A common batch of stabilized plasma-protein solution (SPPS) that was included in the replacement therapy for each patient was found to contain hepatitis B surface antigen (HBsAg). A follow-up study was undertaken of these patients and others who were known to have received SPPS from the same batch (in total, 10 patients were followed for a median of 46.5 weeks). No patient developed evidence of hepatitis, although one patient developed antibody to surface antigen. It was concluded that the manufacturing process was effective in destroying the infectivity of the HBsAg-positive plasma that was used in this batch of SPPS and that the final product was poorly immunogenic in these patients.

HBs antigen in human plasma fractions

Therapeutic fractions were obtained by fractionating human plasma containing HBs antigen, by the Cohn ethanol technique modified by Nitschmann. Plasmas with various HBs antigen titers were selected. The antigen was sought in each fraction by the techniques of counterelectrophoresis and radioimmunological detection in liquid phase. With the exception of very pure albumins, all fractions were found to contain the HBs antigen, though in variable proportions. A technique for the purification of albumin, applicable on an industrial scale, is proposed. It makes it possible to obtain an albumin fraction in which the HBs antigen cannot be detected by the most sensitive techniques, even starting with a plasma which is very rich in HBs antigen (titer 1/64 by counterelectrophoresis).

Immunosuppression, liver injury, and hepatitis in renal, hepatic, and cardiac homograft recipients: with particular reference to the Australia antigen

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The Australia (hepatitis-associated) antigen in fibrinogen and other fractions of human plasma

Human plasma containing the Australia (hepatitis-associated) antigen was fractionated by the cold ethanol method of Cohn, Strong, Hughes, Mulford, Ashworth, Melin, and Taylor (1946) and small aliquots were examined for the presence of this antigen by immunodiffusion and by electron microscopy. The findings were in general agreement with the postulated risk of transmitting hepatitis by blood derivatives. The Australia (hepatitis-associated) antigen was detected in fibrinogen, thrombin, and antihaemophilic globulin as well as in other fractions. The antigen was not found in gamma globulin (immunoglobulin fraction) nor in albumin.The use of radioiodinated fibrinogen for the diagnosis of deep vein thrombosis is discussed and it is concluded that the use of fibrinogen for diagnostic procedures should be assessed against the possible risk of hepatitis.

Incidência de hepatite por sôro homólogo no Hospital das Clínicas da F.M.U.F.Pe

Os autores estudaram mensalmente e por um período de seis meses 62 pacientes através de exames clínico-laboratoriais e que receberam transfusão de sangue no Hospital das Clínicas da F.M.U.F.Pe. Constataram em 3 deles sinais clínicos-laboratoriais e histopatológicos de hepatite por vírus (hepatite por sóro homólogo). Após revisão da literatuta recomendam que os estudos prossigam a fim de que os riscos de transmissão da hepatite pós-transfusional sejam eliminados.