Australia antigen in active chronic hepatitis in Australia: results in 130 patients from three centres

Comparative study of chronic hepatitis: histological differences between Japan and England

A comparative study of chronic hepatitis in two hospitals in Japan and England is reported. Patients seen in England came from a variety of countries and races. Type B chronic hepatitis was common in both hospitals. While CPH, CLH, and mild CAH were more frequently seen in cases from England, two thirds of the cases from Japan showed moderate or severe CAH. The most striking differences among the histological features were plasma cell infiltration and lymphoid follicle formation. The former was more frequent and conspicuous in cases from England, and the latter in non-A non-B cases from Japan. The incidence of bile duct damage and granulomatous lesions was different in the two hospitals. It was concluded that geographical differences should be taken into account when pathogenesis, histological definition, treatment and many other aspects of chronic hepatitis are assessed.

Primary hepatocellular carcinoma in Australia: Aetiological considerations

This is a study of aetiological associations in patients with primary hepatocellular carcinoma (PHC). Thirty new patients with PHC were seen in a five-year period. The most common aetiological association was alcoholic cirrhosis. This was implicated in the development of PHC in 13 patients. However, since the introduction of radioimmunoassay for hepatitis B surface antigen (HBsAg) there have been six patients with HBsAg-associated PHC. Thus, for the first time, an association of hepatitis B virus with PHC is described in this country.

The role of the hepatitis B virus infection in patients with chronic hepatitis in Argentina

Over a seven-year period, we monitored 221 patients with chronic hepatitis from two medical centers. By using the counterlectrophoresis (CEP) test to detect the presence of HBsAg and anti-HBc, or both, we established that 87.7% of them had hepatitis B infection. Serum specimens originally found negative for HBsAg by CEP were further tested by reversed passive hemagglutination (RPH), and those originally found negative for anti-HBc by CEP were further tested by radioimmunoassay (RIA). Five patients were anti-HBc-positive and HBs-Ag-negative. No sex predominance was observed, but HBsAg incidence increased with increasing age. The HBeAg antigen was detected in 46.8% of the 161 cases tested for it; the most frequent subtype found was adw (63.7%). The present findings indicate that HBV infection largely contributes to the development of chronic hepatitis in Argentinian patients.

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.

Detection, by three techniques, of hepatitis B surface antigen (HBsAg) and determination of HBsAg and anti-HBs titres in patients with chronic liver disease

The sensitivities of three technqiues used to detect serum hepatitis B surface antigen (HBsAg) were compared in 411 patients with various types of chronic liver disease. Counterimmunoelectrophoresis proved an unreliable test. Two haemagglutination technqiues were slightly less sensitive than radioimmunoassay but were more rapidly performed. Less sensitive techniques were particularly unreliable in active liver disease where HBsAg titres were low. HBsAg was detected in patients with chronic persistent hepatitis, alcoholic liver disease, chronic active liver disease with or without cirrhosis, and primary liver cell carcinoma. Forty-six of the 68 (68%) HBsAg positive subjects were males coming from outside the United Kingdom. The HBsAg titres in 13 subjects with chronic persistent hepatitis were significantly higher (P less than 0-001) than those in 43 subjects with chronic active liver disease. Corticosteroid therapy did not alter the HBsAg titre significantly. None of the 28 HBsAg positive subjects studied serially for up to two years cleared HBsAg from the serum. Anti-HBs was examined by passive haemagglutination and found in 35 subjects, 26 of whom had no evidence of liver disease, 80% came from abroad. Anti-HBs was believed to be of epidemiological rather than of pathological importance.

Hepatitis B surface antigen (HBsAg) in the liver of patients with hepatitis; a comparison with serological detection

Chronic hepatitis was diagnosed on liver biopsy of 76 patients; 52 (68%)had HBsAg. Of the 52 patients with HBsAg, 23% had HBsAg shown by immunofluorescence on the liver, while it could not be detected with radioimmunoassay on the serum; 77% had HBsAg detectable in liver and in serum, and none had HBsAg in serum only. HBsAg was detected more frequently in chronic aggressive hepatitis and active cirrhosis than in chronic persistent hepatitis and cirrhosis with little activity. No correlation was found in the different forms of chronic hepatitis between the HBsAg status on the one hand, and levels of transaminases, gammaglobulins, and auto-antibodies on the other. Acute hepatitis was diagnosed on liver biopsy of 24 patients; 50% had HBsAg. Liver tissue positivity was very low in the fully developed stage compared to serum positivity. In 146 patients with other liver ailments, both liver and serum were negative for HBsAg.

Hepatitis B antigen and antibody in active chronic hepatitis and other liver diseases in Australia. A multicenter collaborative study

In a multicenter cooperative study, sera from 85 patients with active chronic hepatitis (ACH) were examined for the presence of hepatitis B (Australia) antigen (HBAg) by radioimmunoassay (RIA) and antibody to HBAg (anti-HBAg) by RIA and passive hemagglutination (PHA), the most sensitive currently available techniques. In addition, sera from 83 patients with other liver diseases 98 other hospital patients, and 67 healthy controls were tested. HBAg was detected in 3 of the 85 patients (four percent) with ACH. In a further 3 patients (four percent) anti-HBAg was detected. Thus, 6 patients with ACH (seven percent) had evidence of present or prior infection with the hepatitis B virus (HBV). HBAg was also detected in 7 of the patients with other liver diseases, 2 of the other hospital patients, and none of the healthy controls. Anti-HBAg was detected in 17 of the non-ACH subjects. These results indicate that neither persistent nor prior self-limited infection with HBV is a major factor in the pathogenesis of ACH in Australia.

Histocompatibility antigens in active chronic hepatitis and primary biliary cirrhosis

The frequency of antigens HL-A 1 (48%) and HL-A 8 (52%) in 54 patients with active chronic hepatitis from south-east England was significantly higher than in 89 control subjects from the same region (22% and 17% respectively). No correlation could be detected with the age and sex of the patients or with the presence of a particular immunological abnormality but the frequency of HL-A 1 and HL-A 8 was much lower in the nine patients who were positive for HBAg than in the 45 HBAg-negative cases. These results provide further evidence of the importance of genetic factors in active chronic hepatitis. In contrast the frequency of HL-A 1 and HL-A 8 in primary biliary cirrhosis, both in 45 patients from south-east England and in 28 patients from western Scotland, was not significantly different from that found in control groups from the same regions.

Specific immunodiagnosis of hepatocellular carcinoma by leucocyte adherence inhibition

The leucocyte adherence inhibition test provides a rapid, reliable, and specific technique for the immunodiagnosis of primary hepatocellular carcinoma (malignant hepatoma). The patient's blood leucocytes are tested in vitro for cell-mediated immunity against tumour-associated antigens and the serum is tested for blocking factor which interferes with the immunological reaction. Specific reactivity of both leucocytes and serum was consistently detected in patients with malignant hepatoma, and negative reactions were obtained in other liver diseases including secondary tumours of the liver. The test has provided positive evidence for the presence of hepatoma when more conventional methods gave doubtful or negative results. A positive result preceded the clinical appearance of tumour by up to three years in two patients.

Chronic liver disease: differences in autoimmune serological reactions between Australians and Asians

A total of 164 patients from Australia, Ceylon, India, Singapore, and Thailand were studied for the prevalence of autoantibodies associated with "idiopathic" chronic liver disease-namely, antinuclear antibody, smooth muscle antibody, and mitochondrial antibody. The prevalence of these autoantibodies was high among patients from Australia (55%), but was low among patients from Ceylon (14%), India (11%), Singapore (0%), and Thailand (8%). There are variations in types of hepatitis and cirrhosis between races, and this applies particularly to the type associated with autoimmune markers. This may be related to genetic differences that have evolved between peoples of European and Asian descent.