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A staphylococcus aureus protein A co-operated ELISA (SPA-ELISA) for the detection of anti-HCV-IgM has been established using HCV antigenic polypeptide, SPA-bearing germs and horseradish peroxidase labelled anti-human IgM. The specificity of SPA-ELISA has been confirmed by some substitution tests, blocking tests and destroying test with 2-mercaptoethanol. The results showed that the rate of anti-HCV-IgG in a group of patients with acute hepatitis and there were significant difference in anti-HCV-IgM was higher than that of anti-HCV-IgM detected rates between patients with acute hepatitis and those with chronic hepatitis (32.26%, P < 0.01). On the other hand, the positive rates of anti-HCV-IgM were 53.66% and 63.41% in transfusion associated hepatitis, 38.10% and 42.86% in sporadic hepatitis, 6.11% and 16.33% in people who have had active social activities, 40.00% and 10.00% in a group of blood donors respectively. Furthermore, taking into account the characteristics of HCV polypeptide used, its easiness of manipulation, and elimination of the interference of anti-HCV-IgG in sera, the new SPA-ELISA is believed to be of practical value in clinical and epidemiological studies of hepatitis C.

2346 liver samples from 17 areas in China were investigated for intrahepatic hepatitis D antigen (HDAg) by direct enzyme-labelled technique. HDAg was detected in 167 out of 1764 samples of HBsAg positive individuals with the detection rate of 9.47%. Hepatitis D virus (HDV) infection existed in all the examined areas without any significant difference regarding HDAg detection rate. A relationship of intrahepatic HDAg to the pathologic type of the liver disease was observed. The HDAg detection rate in chronic liver diseases and severe hepatitis was higher than in other liver diseases. It suggested that HDV infection was associated with the progression and chronicity of the liver disease. Studies on the relationship between HDV infection and HBV replication showed that HBV replication might be suppressed by HDV infection. Both HDV and HBV, however, could replicate in the same hepatocyte simultaneously.

28 cases of hemophilia were examined for HCV infection status by using the Kehua anti-HCV ELISA kit of second generation. It was found that the infection rate was 78.5% and the infection rate was even higher with patients who had received transfusions or preparations of coagulatory factors. 10 families of 15 patients were also investigated. It was found that of 15 hemophilia patients, 12 showed positive anti-HCV, while none of their 53 family members exhibited any positive anti-HCV. In 8 children of 9 couples no positive anti-HCV was found. Our results revealed that the hemophilia patient may get infected with HCV by receiving multiple transfusions or preparation of coagulatory factors. The risk of getting infected with HCV via daily-life contact including sexual contact is extremely low.

To explore etiology of acute exacerbation in severe chronic active hepatitis, in situ HBVDNA hybridization was carried out combined with detection of HBV markers in the serum and the liver as well as intrahepatic HDAg in 15 cases. Four subgroups were identified based on the etiological evidence: 1) 9 cases were still undergoing HBV active replication or reactivation with cytoplasmic and membraneous HBcAg expression, often associated with the hepatic necrosis foci; 2) 3 cases showed HBsAg or/and HBVDNA positivity despite absence of HBcAg expression, the membranous and homogeneous HBsAg expression being closely related with hepatic necrosis; 3) 2 cases were HDAg positive; 4) the remaining case exhibited no HBV infection evidence. All findings suggested that HBV active replication or reactivation was the major cause of the exacerbation in severe chronic active hepatitis. In addition, HBV superinfection accounted for over 10% of cases with acute exacerbation. Hepatitis A or C may contribute to some episodes of exacerbation.

Bei 163 Patienten mit Virushepatitis verschiedener Typen bzw. mit schweren Lebernekrosen wurden mittels der modifizierten indirekten Immunfluoreszenztechnik nach Meyer zum Buschenfelde die Leberzellmemtran-Antikorper (LMA) untersucht. 42 gesunde Erwachsene dienten als Kontrolle. Die Nachweisrate der LMA war bei akuter Hepatitis 24,24% (8 von 33 Patienten), bei chronisch-persistierender Hepatitis 25% (15 von 60 Patienten) und bei chronisch-aktiver Hepatitis 71,11% (32 von 45 Patienten). Unter 22 HBsAg-Tragern erwies sich ein Fall als LMA-positiv, dagegen keiner von 3 Patienten mit Lebernekrose infolge von Intoxikation. Bei den 42 Kontrollpersonen erhielten wir mit Ausnahme von 1 Fall negative Resultate. Die Nachweisrate der LMA war bei Patienten mit CAH bei der HBsAg-negativen Gruppe signifikant hoher als bei der HBsAg-positiven Gruppe (8/8 bzw. 24/37), wahrend bei der anderen Gruppe mit anderen Hepatitiden keine deutliche Differenz beobachtet wurde. Die immunologische Bedeutung der LMA in der Pathogenese der CAH wird diskutiert.

Das Lipoprotein der Leberzellmembran, das LSP, wurde durch Chromographie nach der Methode, die von McFarlane beschrieben wurde, aus normalem Lebergewebe isoliert. Zur Charakterisierung des isolierten LSP-Praparates wurde Polyakrylamid-Gel-Elektrophorese durchgefuhrt. Enzym-gekoppeltes Staphylokokken-Protein A Immunosorbens Assay (SPA-ELISA) mit dem gereinigten LSP-Praparat als Antigen wurde zur Bestimmung von Anti-LSP-Antikorper in Seren von Patienten verwendet. Insgesamt wurden 277 Serumproben untersucht. Die Resultate der Untersuchungen in der Hepatitis-Gruppe zeigten, da\ die Nachweisrate von Anti-LSP bei Patienten mit schwerer Hepatitis am hochsten (8/9) und bei Patienten mit CAH die nachsthochste (75%) war. Die Nachweisrate von Anti-LSP in Seren von Patienten mit AH, CPH und von HBsAg-Tragern betrug 47,6%, 38,4% bzw. 30,4%. In den Seren von 46 Normalpersonen zeigte sich aber nur ein Fall Anti-LSP-positiv. In der Gruppe mit anderen Erkrankungen war Anti-LSP positiv in 8 von 13 Fallen mlt Leberzirrhose, 5 von 7 Fallen mit SLE und 2 von 7 Fallen mit chronischer Nephritis. Die Resultate der Untersuchungen zeigten, da\ SPA-ELISA eine empfindliche Methode ist, die in der Klinik leicht durchgefuhrt werden kann. Es bestand eine Korrelation zwischen den Nachweisraten bzw. den Titern von Anti-LSP und Leberschadigung bei Hepatitis. Die Bestimmung von Anti-LSP durfte deshalb eine brauchbare Methode zur Beurteilung der Leberschadigung bei Patienten mit Hepatitis sein.

To explore the role of HBV antigen expression and monocyte infiltrate in situ in chronic hepatitis, HBV markers and compositions and number of monocytes in the liver of chronic hepatitis B were immunohistochemically located and identified, and correlated with hepatocyte necrosis. It was found that hepatic necrosis frequently took place in the centre or boundary of membranous HBsAg and/or HBcAg expression and the majority of monocytes accumulated in the necrotic areas showed CD8+ cell token in HBeAg-positive stage of chronic active hepatitis. On the other hand, with HBeAg positivity converted into HBeAg-negativity or anti-HBe-positivity, HBV antigen expression significantly declined, CD4+ cells remarkably increased as compared to HBeAg-positive status. These findings suggest that there may be distinct pathogenesis of hepatic necrosis in different stages of chronic HBV infection.