Australia antigen and antibody in British patients with leprosy

Seroepidemiological associations between tuberculosis, malaria, hepatitis B, and AIDS in West Africa

Serum samples from 51 patients with malaria, 35 patients with hepatitis B virus infection, 111 patients with tuberculosis, and 166 healthy controls were studied to determine any associations between tuberculosis, malaria, hepatitis B, and AIDS in Nigeria, West Africa. All serum samples were examined for the presence of HIV-1/HIV-2, hepatitis B virus surface antigen (HBsAg), and malaria antibodies. Only one patient was HIV-1 antibody-positive and none HIV-2 antibody-positive. Statistical associations were found between the presence of malaria antibody titres on the one hand and a diagnosis of hepatitis B virus infection (P < 0.05) or tuberculosis (P < 0.05). A stronger association (P < 0.001) was found between the presence of HBsAg and tuberculosis suggesting that HBsAg carriers are at higher risk of contracting tuberculosis.

Hepatic structure and function in Papua New Guineans with leprosy

Hepatic function, including plasma bromsulphthalein (BSP) clearance was studied in 20 Papua New Guineans with leprosy: 11 lepromatous (LL) (6 had erythema nodosum leprosum (ENL)) (group A), and 9 tuberculoid or borderline (BT or BB) (group B); 12 controls (group C) were also studied. Four of five with abnormal BSP results had significant complicating or additional factors (hepatic amyloidosis, pustular ENL, hepato-cellular carcinoma and a pyogenic abscess), compared with two of 15 with normal results (tuberculous osteitis and pyogenic osteomyelitis). In nine (five from group A, and four from group B) needle liver biopsy histology was assessed: foci of vacuolated phagocytes and histiocytes, and tuberculoid granulomata were the most frequent lesions; none had cirrhosis. Leprosy is not associated with impaired hepatocellular function unless a severe complication or coincident disease is concurrently present. In this limited study therapeutic agents were not associated with abnormal liver structure or function. When liver function is abnormal in leprosy, another cause (e.g. secondary amyloidosis, sepsis or malignancy) should be searched for.

Hepatitis-B virus infection in patients with leprosy: a serological study in a leprosarium in Northern Nigeria

The prevalence rates of hepatitis-B surface antigen (HGsAg) and its homologous antibody (anti-HBs) were determined in 62 patients in a leprosarium (42 tuberculoid and 20 lepromatous) and in 40 adults living near the locality. The exposure rate (HBsAg + anti-HBs) was high in both controls and patients, 72.5% and 70.9% respectively, The frequency of HBsAg was significantly higher in patients with lepromatous leprosy (40%) compared with controls (10%) (chi 2 = 5.7 p less than 0.025) but there was no difference in the prevalence rate of HBsAg between patients with lepromatous leprosy (40%) compared with those with tuberculoid leprosy (23.8%) (chi 2 = 1.7 p greater than 0.1). The exposure rate was higher in the lepromatous group (80%) compared with the tuberculoid group (59.5%) but the difference was not significant (chi 2 = 2.87 p greater than 0.05). It is concluded that the high rate of infection in patients with leprosy if not due to a peculiar genetic defect but the result of living in an environment where the virus is highly endemic. The observed significance increase in carriage of HBsAg in lepromatous leprosy is probably due to depressed cellular immune function characteristic of this group of patients. The slightly increased exposure rate to HBV of lepromatous versus the tuberculoid type of leprosy is probably due to increased opportunity for infections from repeated and prolonged stay in hospital.

Hepatitis B antigen, hepatitis B antibody, and subtypes in leprosy

The prevalence of hepatitis B antigen (HBsAg), hepatitis B antibody (HBsAb), and subtypes in 242 cases of leprosy is reported. Patients were divided into three subgroups, lepromatous (174), tuberculoid (55), and borderline (13). A total of 131 patients were tested on admission; the remaining 111 had been institutionalized for a period of 3 months or more when tested. Of the 131 cases tested on admission, 88 were retested 6 to 12 months after admission. There was no statistical difference in the incidence of HBsAg and HBsAb among the three groups or between normal controls and the leprosy patients. The predominant subtype was ADW (84.1%). After institutionalization, one lepromatous case converted to HBsAg positive and four converted to HBsAb positive.

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.