HBs antigen in human plasma fractions

Intravenous immunoglobulin and hepatitis C virus: an overview of transmission episodes with emphasis on manufacturing data

A number of episodes of non-A, non-B hepatitis (NANB) have been associated in the recent past with the administration of intravenous immunoglobulin (IGIV). It now appears that hepatitis C virus (HCV) is the cause of NANB, although not all the factors leading to HCV transmission by IGIV are completely understood. Nevertheless, based on a retrospective analysis of two episodes of HCV transmitted by anti-Rh D immunoglobulin (anti-D), cold ethanol fractionation clearly is important in ensuring viral safety; both of these intravenous anti-D preparations were manufactured without benefit of this purification step. Other episodes of HCV transmission have been associated with IGIV produced using chromatography (particularly DEAE-Sephadex chromatography), which has been used after cold ethanol fractionation to further purify immunoglobulin G. DEAE-Sephadex chromatography may have only a marginal partitioning capacity, such that infective HCV virions are not further fractionated into waste fractions. All IGIV preparations associated with HCV transmission were formulated as lyophilized preparations, which may be important in stabilizing HCV before administration to patients. The role of anti-HCV screening in improving the viral safety of IGIV preparations remains unclear, but additional viral inactivation steps, such as solvent-detergent treatment or incubation at pH 4.0, probably are required for IGIV manufactured using chromatographic procedures.

Ethanol and heat-treated plasma fractionation methods in South Africa

Modifications of the Cohn techniques are the methods of choice for the preparation fo dilute albumin (PPS) and gamma-globulin solutions on an industrial scale. For the manufacture of refined albumin solutions, however, considerable labour and material is saved if crude, ethanol-precipitated fractions are heated in the presence of stabilisers in order to purify the albumin. The technique is simple and cheap, and yields a safe product of high quality. Bacterially contaminated and highly haemoglobinized plasma can be successfully heat-treated.

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.