Persistent viral hepatitis

Jaundice during pregnancy in Ibadan, Nigeria

The clinical features of hepatitis during pregnancy and the effect of this complication on the mother and the fetus were evaluated in 45 patients with jaundice who were treated at the University College Hospital, Ibadan, Nigeria, from July 1976 to January 1978. Viral hepatitis was the cause of jaundice in 23 of the 45 patients in this prospective study. Three of these patients had the fulminant type of jaundice which resulted in maternal deaths. The peak incidence of the disease occurred in the last trimester. Hepatitis had a deleterious effect on the outcome of pregnancy; the effect was directly related to the severity of the disease, especially when associated with pyrexia. It is postulated that, by lowering resistance to infection, malnutrition may play a significant role in the pathogenesis of hepatitis during pregnancy.

Hepatitis-B: a review

The recent literature on various aspects of hepatitis-B is reviewed with emphasis on the interrelationships of viral structure, antigenic components, and host immune response in acute, chronic, and asymptomatic carrier states of the infection. The mode of replication and mechanisms of transmission are discussed. Special attention is paid to potential non-parenteral routes of spread. The role of hepatitis-B in associated immune complex diseases and in hepatoma is outlined. A guide to the interpretation of serologic tests for hepatitis-B associated antigen and antibody patterns is presented in relation to the clinical stage and prognosis of the infection. Therapy, except in conceptual terms, is not covered but a summary of the current status of active and passive immunization is given. The unresolved question of the infectivity of carrier medical staff for their patient contacts, and the reverse, is discussed.

ad and ay subtypes of hepatitis B antigen in a case of hypogammaglobulinaemia

We describe the finding of d and y specificities of hepatitis B surface antigen (HBsAg) in a case of hypogammaglobulinaemia of the 'common variable' type treated with fresh frozen plasma infusions. Absorption studies show that the two specificities are on separate particles, suggesting dual infection. It raises important questions regarding the relationship between HBsAg persistence and the immune status of the carrier.