Hepatitis-associated antigen (Australia antigen) in Massachusetts blood donors

Chemical liver function tests and epidemiologic studies of HBsAg positive blood donors

The HBsAg positivity in age, sex, occupation, blood type, past history and chemical liver function tests were analyzed in 869 cases without symptoms of liver disease and positive testing for HBsAg by RPHA method, who were selected among 11, 197 blood donors of the Red-Cross Blood Bank in Pusan, Korea from August 1, to September 30, 1982. The following results were obtained: 1. The overall HBsAg positivity in random blood donors was 7.76%. 2. The HBsAg positivity of males was 8.36% and females 6.0%; males had a slightly higher positivity than females. 3. The HBsAg positivity of the 16–20 year old age group had the highest frequency (9.05%), 21–25 year old age group 8.23%, 26–30 year old age group 5.72%, 31–35 year old age group 5.76%, 36–40 year old group 5.85%, 41–45 years old age group 4.76%, and 46–50 year old age group 3.7%. HBsAg positivity had decreasing tendency of frequency by increasing age. 4. The HBsAg positivity of the merchant group had the highest frequency (10.26%), and next, the unemployed, salary man, student, soldier, in order of frequency. 5. The HBsAg positivity in cases with blood type A had the highest frequency (8.07%), and next, cases with B type, O type, and AB type in order of frequency. 6. The HBsAg positivity in cases with no past history in liver disease had the highest frequency (75.37%), and next, cases with history of liver diseases among family 12.54%, hepatitis with jaundice 5.06%, admission due to other diseases except liver diseases 3.57%, transfusion 2.42%, hepatitis without jaundice 1.04%. 7. In chemical liver function tests of HBsAg positive blood donors, elevation of SGPT level showed highest frequency (10.70%), SGOT 7.7%, total serum bilirubin 5.29% and elevation of one or more than of SGPT, SGOT, total serum bilirubin 18.99%.

Incidence of hepatitis B in the penitentiary of New Mexico

A study was conducted to determine the incidence of hepatitis B (HB) in a prison population. Forty-seven per cent of 455 male prisoners had evidence of past HB infection. HB seropositivity was most strongly correlated with: 1) a history of IV drug abuse; 2) age; 3) total time in any prison; and 4) race. During a one-year study period there were no clinical cases of HB in the prison and the seroconversion rate was 0.8 per cent among prisoners still incarcerated.

Hepatitis-associated with markers in the American Red Cross volunteer blood donor population. III. Influence of donor selection practice upon HBsAg prevalence

The American Red Cross collects blood from a number of defined subsets of the donor population and teh proportion of blood collected from each subset varies widely from center to center. A large part of the variation in prevalence of HBsAg may be related to variations in the proportion of blood collected from plants and factories, military units and schools or colleges. We have derived a regression equation, significant at the p less than 0.001 level, which links HBsAg prevalence with these collection parameters. Using this equation, we were able to predict the prevelance of HBsAg among first-time donors in 6 of the 9 geographic divisions of the United States with an accuracy exceeding 10%. The predictions for the remaining division were within 35% of the actual value. Correlation studies were supported by measurements of true donor prevalence in three blood centers.

Hepatitis B antigen and antibody among staff members of an Israeli hospital and a kibbutz population

Until recently, hepatitis type B was thought to be transmitted parenterally. However, much evidence has appeared regarding non-parenteral transmission. Hospital personnel are exposed both ways to this disease. We compared the incidence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) among 388 workers at a major medical center in Israel with 203 kibbutz residents, using radioimmunoassay procedures. Of the hospital personnel, 1.8% were found to carry the antigen and 23.9% the antibody. In contrast, 0.5% of kibbutz personnel were antigen-positive and 11.8% carried the antibody. The highest incidence of antibody was found among people born in middle-eastern countries outside of Israel. These results show a significant increase in the exposure of hospital personnel to hepatitis B virus. A marked increase in the frequency of sera positive for anti-HBs occurred after the first year of hospital work.

Hepatitis B antigen--a survey in a major metropolitan hospital

The prevalence of hepatitis B antigen in blood donors in the Wellington Hospital region is 0-27%. A retrospective survey of 66 persons found by the Wellington Hospital Laboratory to be hepatitis B antigen positive between September, 1971 and August, 1975, showed that over this period there has been a consistent decline in the number of new antigen positive cases found per year. This appears to be due to a decline in the numbers originating in the renal unit. A liver biopsy was taken in only one case and this showed chronic persisting hepatitis. Apart from the renal unit, high risk patients and staff are not tested regularly for hepatitis B antigen. Regular testing of laboratory staff and patients and staff of the cardiothoracic and haematology departments is recommended.

Hepatitis B antigen and antibody in the U.S. Army: prevalence in health care personnel

The prevalence of Hepatitis B surface antigen (HB(S)Ag) and antibody (anti-HB(S)) seropositivity and the association of seropositivity with demographic, personal health, and professional experiences were studied in a cohort of Army Medical Department officer personnel. Serologic evidence of Hepatitis B infection was found in 5.0 per cent of personnel and was associated with age, sex, place of birth, history of hepatitis, history of blood transfusion, and previous overseas assignments. Seropositivity rates were higher for patient care oriented officer personnel, especially for those in surgical specialties, and rose with increasing professional experience. These data present a composite of risk factors operative in the acquisition of Hepatitis B seropositivity and identify a cohort for prospective study.

Prevention of post-transfusion hepatitis. Role of sensitive hepatitis B antigen screening tests, source of blood and volume of transfusion

Aliquots from units of blood were screened by radioimmunoassay (RIA) and reverse passive hemagglutination (RPHA) shortly after transfusion. Recipients of positive units, as well as control subjects, were followed prospectively for evidence of either post-transfusion hepatitis (PTH) or exposure to hepatitis B (HB). There was a significant correlation between receipt of either an RPHA-positive or RIA-confirmed positive unit and the subsequent development of PTH or HB exposure. Recipients of all volunteer units had a lower incidence of PTH than did recipients of all commercial units. The frequency of PTH and HB exposure was not statistically different in groups receiving 1 to 5, 6 to 10, 11 to 20 and greater or less than 21 units of blood. The PTH seen in the study presented over a wide clinical spectrum, but it was usually anicteric and frequently asymptomatic.

Prevalance of antibody to hepatitis B surface antigen in various populations

Sera from individuals with different degrees of exposure to the agent of hepatitis B were tested for antibodies to hepatitis B surface antigen (anti-HB-s) by passive hemagglutination and for hepatitis B surface antigen (HB-s Ag) by radioimmunoassay and immunoelectroosmophoresis. In a plasma fractionation plant, anti-HB-s was detected in 82 percent of workers processing human plasma and 3.3 percent were healthy carriers of the antigen. Fifty-six percent of the workers having only casual contact with plasma processing exhibited anti-HB-s and 24 percent of workers with no contact had anti-HB-s, yet HB-s Ag was not found in either of these two groups of workers. A similar correlation was shown in hospital personnel; 31 percent of employees with direct contact to serum specimens and only 8 percent without direct contact had anti-HB-s. The frequency of HB-s Ag (0.8 percent in patients with disorders not involving the liver; 49.8 percent in patients tentatively diagnosed as viral hepatitis) and anti-HB-s (14.5 percent to 28.5 percent, respectively) in selected groups of hospitalized patients varied greatly. In 508 paid blood donors, anti-HB-s was present in 19.9 percent, whereas it was present in only 6.6 percent of 1,146 volunteer donors. These data demonstrate a correlation between frequency of exposure to human blood or blood products and the prevalence of anti-HB-s.

Asymptomatic liver disease in hepatitis B antigen carriers

Thirty-four healthy blood donors, found to be persistent HBAg carriers, have been investigated by means of serial liver function tests, bromsulphthalein (BSP) retention, and liver biopsy. Thirty-one of the donors had histological abnormalities including one with cirrhosis, three with chronic aggressive hepatitis, and 11 with chronic persistent hepatitis. In 13 biopsies there were focal areas of necrosis in the liver parenchyma. Serial liver function tests revealed abnormalities in each of the donors with cirrhosis or with chronic aggressive hepatitis, in seven of the 11 donors with chronic persistent hepatitis, and in seven of the 13 with focal parenchymal necrosis. The degree of BSP retention was greatest (>11%) in the donors with chronic aggressive hepatitis. The severity of the histological changes was related neither to the titre of the antigen in the serum nor to the presence of autoantibodies.

Liver disease and cell-mediated immunity in hepatitis-associated antigen (HAA) carriers

As the incidence of liver disease in hepatitis-associated antigen (HAA) carriers has not been defined and it has been postulated that continuing liver disease is associated with incompetence of the cell-mediated immune system, a prospective study was undertaken to examine both these points.An increased incidence of HAA carriers was found in a prison population (1.3%). Eighteen of these subjects gave informed consent to further study with liver function tests, liver biopsy, and testing of cell-mediated immunity with dinitrochlorobenzene (DNCB) skin sensitization. Liver function tests were normal in 10 subjects, mildly abnormal in six (SGPT < 100 IU/litre), and abnormal in two. Serum proteins were normal in all. Liver biopsy showed that five subjects had chronic aggressive hepatitis, three of whom had normal liver function tests. Eight subjects had persistent hepatitis, three with normal liver function tests. The remainder had acute hepatitis (1), evidence of residual hepatitis (1), or non-specific changes (2). Only one subject had normal histology. Drug addicts, who comprised 56% of the group, had more severe liver disease then those who were not addicts. The hypothesis that persisting liver disease is associated with impaired cell-mediated immunity was not confirmed in that nine of the 12 subjects with persistent or chronic aggressive hepatitis had a positive response to dinitrochlorobenzene skin sensitization, thus implying normal cell-mediated immunity. The findings of this study suggest that in the presence of continuing antigenaemia liver biopsy is mandatory in order to disclose treatable liver disease.