Hepatitis B e antigen and antibody activity in hepatitis B virus infection

Hepatitis B in seven hospitals for the mentally handicapped

Patients in seven hospitals for the mentally handicapped were screened for markers of hepatitis B infection. Of 2239 patients, 123 (5.5 per cent) were carriers of hepatitis B surface antigen (HBsAg) and a third of these were 'infectious' (negative for antibody to hepatitis B e antigen). Patients with Down's syndrome (DS) were 18 times more likely to be 'infectious' carriers than those without, and male patients were six times more likely to be 'infectious' carriers than female patients. There was a wide difference in carrier rate among the various hospitals. In the hospital with the highest carrier rate (12.5 per cent), 60 per cent of male patients with DS were carriers of HBsAg and of these two-thirds were 'infectious'. The carrier rate decreased with age, but the proportion of carriers who were hepatitis B e antigen positive was unaffected by age.

Hepatitis B e antigen and antibody in asymptomatic Chinese with hepatitis B surface antigenemia in Taiwan

Two hundred and twenty two asymptomatic carriers of hepatis B surface antigen (HBsAg) with age between 4 months and 68 years, 172 healthy persons with antibody to HBsAg (anti-HBs) and 85 healthy persons seronegative for both HBsAg and anti-HBs were studied by double immunodiffusion for the evaluation of the meaning of hepatitis B e antigen (HBeAg) and its antibody (anti-HBe). In 222 asymptomatic carriers, HBeAg was detected in 32.4% and anti-HBe in 31.5%. The geometric titer of HBsAg was 1:2159 in the HBeAg positive and 1:149 in the anti-HBe positive persons. Frequencies of HBeAg and anti-HBe in asymptomatic carriers of HBsAg correlated closely with age. The highest frequency of HBeAg was found in the first decade in 64% decreasing steadily to 20.8% in the fourth and then suddenly down to 4.1% in the fifth decade. A reverse trend was observed in anti-HBe frequency. From our analysis, it is likely that the high frequency of HBeAg in serum of Chinese, especially in females of fertile age, might be an important contributing factor for the high rates of hepatitis B virus (HBV) infection and HBsAg carrier in Taiwan. The presence of HBeAg/anti-HBe system is not only a market of infectivity and prognosis but also a chronologic marker of HBV infection.

Hepatitis B infection in pediatric dialysis and transplant patients: significance of e antigen

We examined the clinical significance of hepatitis Be antigenemia in 36 HBsAg positive pediatric dialysis and renal transplant patients. One hundred twenty-seven sera were tested for HBeAg and anti-HBe. Seventy-three sera (57%) from 29 patients (81%) contained HBeAg. The presence of HBeAg was associated with an increased titer of HBsAg (P < 0.005) and with the presence of the HBsAg carrier state (P < 0.001). HBeAg was found in 40% of specimens taken from dialysis patients, and in 70% of specimens from transplant patients (P < 0.001). No serum contained anti-HBe, although 28 of 29 sera (97%) tested had antibody to HBcAg. No association was found between the presence of HBeAg and serum aminoleucine transferase levels or the histologic evidence of chronic active hepatitis. Fifteen HBeAg negative sera from patients persistently positive for HBsAg were tested for HBV-specific DNA polymerase activity; 7 (47%) had significant activity. Since both HBeAg and DNA p are indicators of infectivity, many HBeAg negative sera from immunosuppressed HBsAg carriers may be infectious.

Vertical transmission of hepatitis B surface antigen in carrier mothers in two west London hospitals

126 children of 102 hepatitis B surface antigen (HBsAg) carrier mothers were delivered at Hammersmith Hospital and Queen Charlotte's Maternity Hospital, between 1971 and mid-1978. Blood tests on 110 of these children showed that 8 out of the 18 with Chinese mothers, but only 6 out of the 92 other children, have become HBsAg positive. The presence of maternal hepatitis B e antigen (HBeAg) is also significantly correlated with transmission of HBsAg to the children. The management of children whose mothers are carriers is discussed.

Hepatitis B "e" antigen: an apparent association with lactate dehydrogenase isozyme-5

Serums containing the "e" antigen of hepatitis B virus were subjected to electrophoresis in polyacrylamide gel. An extra band appeared in the lactate dehydrogenase isozyme pattern, but this band was undetectable in serums containing antibodies to the e antigenic determinant. Prior separation of the lactate dehydrogenase isozyme-5 fraction by chromatography of serum on minicolumns of diethylaminoethyl-Sephadex-A50 improved electrophoretic identification of the extra band. Neutralization with antibodies to the e antigen as well as by antibodies to the homologous d or y component of the hepatitis B surface antigen removed the extra band; antibodies to the lactate dehydrogenase isozyme-5 removed both the normal and the extra enzymatic band of isozyme-5. This feature of the e antigen provides an assay system for laboratory diagnosis of potential clinical usefulness and suggests its possible role in pathogenesis of hepatocellular injury.