Detection of hepatitis b surface antigen in patients with acute viral hepatitis

Acute hepatitis B in a metropolitan population

One hundred and fifty-three patients with acute hepatitis B infection over a four-year period have been reviewed. They were predominantly young males (60%) with a mild illness. There was no indication of the source of the infection in 56 patients (36%), while 52 patients (34%) had a history of intravenous narcotic abuse. Twenty-five patients were hospital staff members, while the remainder had known environmental associations with the hepatitis B virus. Eight of the 80 patients who were followed up for longer than six months had persistent hepatitis B surface antigenaemia, and evidence of progression to chronic hepatitis.

Emerging patterns of hepatitis B chronic liver disease in Australia

Until now, the hepatitis B virus has been thought to play a minor role in the aetiology of chronic liver disease in Australia. This is a report of 21 patients with cirrhosis and/or primary hepatocellular carcinoma with hepatitis B antigenaemia. Primary hepatocellular carcinoma occurred in six patients, five of whom had underlying cirrhosis. The disease occurred mainly in non-Australian born males, and was not often associated with a previous history of hepatitis. The death of 16 patients within 12 months of presentation is in contrast to previous concepts of the benign nature of hepatitis B associated cirrhosis.

Viral hepatitis and intrahepatic cholestasis of pregnancy

Specific serological tests which are now available for the diagnosis of infection with hepatitis A and hepatitis B viruses, were used to distinguish viral hepatitis from other causes of liver disease in pregnancy. Forty-nine (51.6%) of 95 pregnant patients had viral hepatitis, 24 hepatitis A and 25 hepatitis B. The majority of patients (26 of 28) presenting before 22 weeks gestation had viral hepatitis. By contrast, 23 (34.3%) of the remaining 67 patients presenting with abnormal liver function tests at greater than or equal to 22 weeks gestation, had viral hepatitis; the majority of the remainder had features compatible with intrahepatic cholestasis of pregnancy. Although there were significant clinical and biochemical differences between the two groups, accurate diagnosis was only possible by using specific virological tests.