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Kinetic studies have revealed the direct solid phase radioimmunoassay for hepatitis B antigen (Ausria, Abbott Laboratories) to be markedly sensitive to incubation temperature. The present 18-hour room temperature incubation can be reduced to 2 h at 50 °C without loss in test sensitivity. The rapid test is also considerably more specific than that carried out under standard conditions. If licensed, this modification would permit HB Ag screening by RIA to be carried out on labile blood products.

SummaryThe adenosine triphosphatase (ATPase) assay for avian myeloblastosis virus (AMV) was modified to produce greater sensitivity and reproducibility. With the new assay, and virus cultivated in vitro, the relationship between adenosine triphosphatase activity and virus concentation was linear between 1 × 1012 and 1 × 108 particles/ml. This assay was, however, tenfold less sensitive when virus in avian plasma was assayed. Rate zonal and equilibrium density gradient centrifugation experiments confirmed the specificity of the reaction.We are greatly indebted to Drs. Joseph and Dorothy Beard for providing initial stocks of virus and of myeloblasts, and for generous gifts of time and hospitality involved in introducing us to the methodology of work with avian myeloblastosis. Skilled and conscientious technical assistance was provided by Miss Kathleen Burke and Mrs. Eva Zanati.

SummarySix Group “B” and 2 Group “A” arbor viruses were found to be highly susceptible to inactivation by neutral red in the presence but not in the absence of visible light.Inactivation kinetics with Japanese encephalitis virus were first order and proceeded for more than 8 log units when high titer stocks were investigated.The possible application of this method of inactivation to the production of killed virus vaccines was discussed.

In a survey among 449 family contacts of blood donors from 197 households containing carriers of hepatitis B antigen, 6.7 per cent were antigen positive, as compared with 0.8 per cent in control households. The greatest prevalence of B antigen was among siblings (19.7 per cent) and other genetic family contacts (8 per cent). In spouses B antigen was less frequently detected (3.4 per cent). Hepatitis B antibody was detected three times more frequently in the study households than in control households. No differences in prevalence of hepatitis B antibody between specific relatives of antigen carriers were seen. Familial clustering does not appear to be correlated with the presence or absence of liver damage in the asymptomatic donor carrier. Neither venereal nor Maternal-Fetal transmission seems to be of primary importance in the spread of hepatitis B infections in these surveyed families. The evidence supports the hypothesis that hepatitis B virus can be transmitted nonparenterally. (N Engl J Med...

We have previously reported detection of Au-SH antigen in six of seven clinically and histologically characteristic cases of polyarteritis nodosa (PAN). 1 Independently, Gocke et al found this antigen in four of 11 cases. 2 In this communication, we shall review the clinical and serological findings on 15 patients with PAN in whom Au-SH antigen or antibody by agar gel diffusion (AGD), 3 immunoelectroosmophoresis (IEOP), 4 by passive hemagglutination (HA), and hemagglutination inhibition (HAI). 5 Results The Au-SH antigen was found in seven out of 15 cases of PAN in Lyon, France. Antigen was not detected in most cases if the disease had persisted for many years. A total of 14 cases of PAN with detectable Au-SH antigen and one case with Au-SH antibody were studied with the cooperation of several colleagues. Detailed serologic data on these cases are summarized in the Table. Antigen was detected during the first 3

This chapter presents the electron microscopic observations on serum hepatitis (SH) antigen, which have been obtained using positive staining. SH antigen, which is identical with the Australia (Au) antigen, has been observed in the serum in acute and chronic liver diseases. Electron microscopy shows that this antigen is located on a 200 A spherical structure. The results of the experiments indicate that the outer membrane of the 430 A particles is similar to the membrane of the 200 A particles, in staining characteristics and morphology. Because only the central core of the large particle stains positively with uranyl acetate, only this form of SH containing particle can contain nucleic acid and possibly be a virus. The electron microscopic observations, based on differences in staining properties, indicate that only the larger of these particles might contain nucleic acid.

In a comparison of 347 chronic carriers of the SH antigen and 8,864 controls with respect to ABO and Rh blood group distribution no significant differences have been detected.

The distribution of transaminase values in a series of 1,906 sera drawn from clinically normal Republic of Korea Army recruits has been analyzed statistically. The data have indicated the existence of two normally distributed populations, and the hypothesis has been presented that one of these populations represents the normal population, characterized by absence of hepatocellular damage; and the other represents an “abnormal” population characterized by the presence of definite hepatocellular damage. The data have been analyzed, and interpreted, with reference to the concept of “normal values,” frequency of anicteric serum hepatitis carriers, ratio of anicteric to icteric serum hepatitis, and the problem of exclusion of anicteric serum hepatitis carriers from blood bank procedures. It is suggested that climination of bloods having SGPT concentrations of greater than 25 units, in this or similar populations, may result in elimination of approximately SO per cent of cases of anicteric hepatitis, with an associated loss of only about 15 per cent of available blood.

187 pools of mosquitoes caught in the wild in Kenya and Uganda have been examined for the presence of the hepatitis B (H.A.A., SH, Australia) antigen. This antigen was detected by solid-phase radioimmunoassay in 28 pools representing eight different species. These data suggest a possible role for blood-sucking arthropods in transmission of hepatitis-B infections in the tropics and in other areas. The high prevalence of chronic hepatitis-B infections in the tropics may depend on blood-sucking arthropod vectors to assure a high frequency of exposure in the early years of life when the risk of developing chronic hepatitis-B-virus infections is greatest.

The passive haemagglutination assay has revealed circulating SH antibody in the serum of 16 of 58 chronic SH carriers. The quantity of this antibody did not correlate well with the degree of liver damage. Rate-zonal density-gradient centrifugation revealed sera with coexisting antigen and antibody to contain rapidly sedimenting immune complexes. The presence of such complexes did not correlate well with the presence or absence of chronic active hepatitis or polyarteritis nodosa. These and other data are interpreted as suggesting that, although the pathogenesis of chronic hepatitis and polyarteritis nodosa most probably involves immune mechanisms, these are not mediated by pathogenic immune complexes composed of SH antigen and antibody.

Serums from patients with acute viral hepatitis were tested for the presence of the serum-hepatitis (SH) antigen to determine whether this would permit distinction between the two major ty...

Specimens of blood from 1,098 patients and employees at two institutions for the mentally retarded were tested by the passive hemagglutination assay for the presence of antibody (HB Ab) against the antigen of hepatitis B (HB Ag). The test was found to be highly specific and sensitive. Twenty-six of 52 patients newly admitted to one institution developed either HB Ag or HB Ab during an 18to 30month period of follow-up. None of these 26 developed overt hepatitis; this indicates a ratio of infection to overt hepatitis of >26:1 in this population. Fortythree percent to 52% of all patients tested and 20% of employees tested were found to have detectable amounts of HB Ab, which tended to persist for long periods. The prevalence of HB Ab, in contrast to that of HB Ag, was consistently lower among mongols than nonmongols. These findings suggest an immunologic deficiency in patients with mongolism. The prevalence of HB Ab was closely related to the duration of institutionalization. Other variables that have been found

The development of complement-fixing antibody to cytomegalovirus was determined in 152 prospectively studied patients. Seven per cent of 59 patients who received only a single unit of blood, 21 per cent of 72 patients with multiple transfusions, and 52 per cent of 21 immunosuppressed transplant recipients showed seroconversion an average of eight weeks after transfusion. The immunosuppressed transplant patients were found to have a significantly enhanced immune response. The risk of seroconversion correlated with the volume of blood transfused, but not with the use of fresh blood, or with the presence of pre-existing complement-fixing antibody. Post-transfusion hepatitis, mostly subclinical, occurred in 23 patients, of whom SH antigen developed in four and cytomegalovirus seroconversion in eight. Twenty-two patients with seroconversion, however, did not give any evidence of hepatitis. Our findings support, but do not unequivocally prove, the hypothesis that cytomegalovirus infections may be trans...

The present article represents a consensus view of the appropriate utilization of chimpanzees in AIDS research arrived at as a result of a meeting of a group of scientists involved in AIDS research with chimpanzees and bioethicists. The paper considers which types of studies are scientifically justifiable in this species, the conditions under which such studies should be carried out, and the conditions which should be encouraged for post-experimental retirement of these animals.

Hepatitis B immune globulin (HBIG) is now a licensed and available product. It is currently recommended for use in prevention of hepatitis B infection after acute exposure to blood infected with he...

Infectious hepatitis and serum hepatitis have been distinguished in the past largely on epidemiologic grounds, the former being characterized by a shorter incubation period, high rate of contact tr...

Five hundred eighty-three patients and 451 medical personnel of 15 hemodialysis centers were surveyed for hepatitis B infections. Hepatitis B antigen (HB Ag) was detected in 16.8% of the patients and in 2.4% of the medical staff; specific antibody to HB Ag (HB Ab) was detected in 34.0% and 31.3%, respectively. The cumulative prevalence of HB Ag and HB Ab varied widely among the centers. The prevalence of HB Ag or HB Ab in patients was related to duration of dialysis treatment, but not to blood transfusions. Significant differences in prevalence of serologic indicators of hepatitis B infection among various staff categories were not observed. Sixty-one percent of family contacts of dialysis patients with a history of hepatitis B infection were found to have HB Ag or HB Ab.

Vaccines represent one of the most effective, economical, and often the only means for prevention of infectious diseases. Nevertheless, as widely noted, all is not well with the vaccine field. During the past decade, pharmaceutical manufacturers have progressively reduced their involvement with vaccines. More and more, essential vaccines are being produced by single manufacturers in the United States. Many factors have been cited to account for this distressing trend: high ratios of costs of development to return on investment as compared with the development of drugs, regulatory delays, and fear of litigation connected with supposed vaccine-related injury. Research and development in the vaccine area has suffered as a result of this disinterest on the part of the pharmaceutical industry, as well as from the many competing demands on the federal biomedical research budget. This is especially disappointing in light of the exciting new possibilities for vaccine development due to the

"Non-A, non-B (NANB) hepatitis" is a term that has been given to the viruses that cause hepatitis in man other than the well-characterized hepatitis viruses type A and B. Since these agents are of great clinical and public health importance, a volume summarizing current knowledge, most of which is of recent origin, was much needed. R. J. Gerety has admirably fulfilled this need by bringing together in one volume a collection of excellent reviews by active workers in this field. These authors have reviewed the history, diagnosis, clinical course, and epidemiology of the disease and have described in detail the results of studies in experimentally infected chimpanzees, including a description of the light and electron microscope findings. The controversial and confusing area of putative NANB-specific antigens and particles is also carefully reviewed, although Gerety seems to be more optimistic regarding the specificity of immunofluorescent methods of NANB antigen detection than

The incidence of primary liver cancer (PLC) varies widely in different areas of the world. It is an important disease in India, in the Far East, and especially in parts of subsaharan Africa. Although seldom seen in Europe and in America, the estimated incidence is three per 10,000 in Senegal where the present study was made. It accounts for 24% of all cancer in men and 5% in women, while in Europe this proportion does not exceed 1% to 3% according to the most recent statistics, standardized for age. 1 The cause(s) of PLC that might explain this special geographic distribution remain unknown. Several hypotheses have been advanced. Malnutrition has few supporters, while genetic predisposition possibly would have only a contributing effect. The most popular hypothesis is that food contains hepatocarcinogenic substances, such as cycasin, pyrolizidine alkaloids, and especially aflatoxin. 2 Some investigators have advanced an oncogenic role for the

Liver sections from 44 consecutive autopsies of addicts (none died of liver disease) were compared with 28 age-matched nonaddict controls and 28 controls with gross liver abnormalities. Fo...

Conventional methods for detection of SH (Australia antigen, HAA) antigen and corresponding antibody, such as agar gel diffusion (AGD), immunoelectroosmophoresis (IEOP), and complement fixation (CF), have failed to incriminate hepatitis virus type B in a major portion of cases of posttransfusion hepatitis. 1,2 It has not been possible to determine whether this reflects only the inadequate sensitivity of these assay methods or whether these findings reflect the role of other viruses, lacking an association of the SH antigen, in the etiology of posttransfusion hepatitis. It has been recognized that introduction of more sensitive methods, such as radioimmune assay 3 or hemagglutination inhibition (HAI) 4 may provide an answer. We report an investigation of patterns of immune response as shown by passive HA technique in 35 patients inadvertently transfused with blood containing SH antigen. Serological evidence of infection with hepatitis virus type B has been obtained in 34 of the 35