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Biomedical subjects

A M Prince

Publications and source records attributed to A M Prince.

At least 199 records · Page 11Linked to original sources

Hepatitis B antigen (HBSAg) and/or antibodies (anti-HBS and anti-HBC) in fulminant hepatitis: pathogenic and prognostic significance.

Hepatitis B surface antigen (HBSAg) and antibodies to both the surface and core antigens of the hepatitis B virus (anti-HBS and anti-HBC) have been studied in 64 consecutive cases of fulminant hepatitis. HBSAg was detected by counterelectrophoresis in 23 (35-9%) but by radioimmunoassay in 38 (59-3%). Anti-HBS was detected by passive haemagglutination in 26 (40-6%), coexisting HBSAg and anti-HBS were found in 16 cases (25%). Using an indirect immunofluorescence technique, anti-HBC was found in all of the cases in whom either HBSAg or anti-HBS was present. The highest survival rate was observed in patients with no evidence of HBV infection (31-3%) and was lowest in those who had both HBSAg and anti-HBS detected simultaneously (6-2%). The prognosis of those who exhibited anti-HBS only was no better than those with HBSAg alone. In a further case, transient interruption of the asymptomatic chronic HBSAg carrier state with seroconversion to anti-HBS was associated with the development of a fulminant hepatitis syndrome. The results suggest that an unusually strong and rapid immune clearance of HBSAg may be involved in the pathogenesis of fulminant hepatitis.

Adolescent↗

Absence of complete homologous immunity in hepatitis B infection after massive exposure.

Evidence from prospective studies of human cases of posttransfusion hepatitis observed among 299 cardiac surgery patients, and from each of three experimentally challenged chimpanzees, indicates that immunity to hepatitis B infection can be overcome by massive challenge doses. However, all cases of hepatitis in patients with prior immunity have been subclinical. Chimpanzees developed hepatitis and HBs antigenemia when challenged with hepatitis B virus that had an antigenic subtype identical to that used in the primary infection. This response provides evidence against the role of differences in antigenic composition of initial and challenge strains of virus as an explanation for incomplete homologous immunity.

Adult↗

Hepatitis BS antigen, malaria titers, and primary liver cancer in South Vietnam.

A total of 306 individuals from South Vietnam were studied: 61 had a diagnosis of primary liver cancer (38 had a tissue diagnosis, and 23 had a clinical diagnosis and a positive alpha-fetoprotein); 9 had viral hepatitis; 101 were hospitalized patients (60 with various other forms of liver disease and 41 without liver disease); 94 were blood donors; 29 were drug users, and 12 were medical students. Alpha-fetoprotein was present in 45 of 61 (74%) of those with a diagnois of primary liver cancer (PLC) and in none of the other patients. Using immunoelectroosmophoresis, hepatitis BS antigen (HBSAg) was found no more frequently in those with PLC than in the other groups studied. In contrast, using a radioimmunoassay technique HBSAg was present 3 to 8 times as frequently in the PLC patients as in other subjects without viral hepatitis. There was a close relationship between the presence of alpha-fetoprotein and HBSAg in the patients with PLC. Malaria seropositivity rates were no different in the PLC groups than the other groups. It appears that in South Vietnam PLC is associated with an increased frequency of HBSAg.

Adolescent↗

Detection of e antigen and antibody: correlations with hapatitis B surface and hepatitis B core antigens, liver disease, and outcome in hepatitis B infections.

Testing for e antigen and antibody (anti-e) was performed by immunodiffusion and counterelectrophoresis in patients with polyarteritis nodosa fulminant hepatitis, and chronic active hepatitis (CAH), in 59 asymptomatic carriers of hepatitis B surface antigen (HBsAg) who underwent liver biopsy, and in 150 carriers followed with sequential SGPT determinations. Counterelectrophoresis was more sensitive that immunodiffusion. Neither e antigen nor anti-e was found in the absence of HBsAg. Among HCsAg-positive patients with polyarteritis nodosa and CAH, e antigen was found in 16 of 18 and 13 of 22, respectively. It was not found in any of 43 patients with fulminant hepatitis, of whom 24 were HBsAg-positive. The e antigen was detected in none of 13 biopsied carriers with normal histology, 4 of 28 with nonspecific changes of 11 of 18 with CAH or chronic persistent hepatitis. Conversely, anti-e was present in 9 of 13 with normal biopsy, 7 of 28 with nonspecific changes, and none of 18 with CAH or chronic persistent hepatitis. The e antigen was found more commonly in nonbiopsied carriers with elevated SGPT, and anti-e in those with normal SGPT. Six carriers whose antigenemia terminated spontaneously had anti-e. The presence of e antigen correlated with a high titer of HBsAg, and with immunofluorescent detection of hepatitis B core antigen in the nuclei of hepatocytes. Conversely, anti-e was associated with significantly lower titers of serum HBsAg (P less than 0.001) and lack of detectable hepatitis B core antigen in the liver.

Alanine Transaminase↗

Clinical trials of hepatitis B immune globulin. Development of policies and materials for the 1972-1975 studies sponsored by the National Heart and Lung Institute.

Plasma from persons with high titers of hepatitis B antibody (anti-HBs) was used to manufacture one lot of hepatitis B "immune" globulin sufficient for four interlocking clinical trials of prevention or modification of hepatitis B infections. The trials were carried out in renal dialysis units, in medical personnel with accidental exposures to hepatitis B, in transfused patients, and in patients with fulminant hepatitis. A single policy board developed protocols that allowed comparisons among the four studies while respecting the unique requirements of each.

Antibodies↗

Hepatitis B "immune" globulin: effectiveness in prevention of dialysis-associated hepatitis.

A randomized, double-blind, multicenter study of hepatitis prevention by immune serum globulin with high anti-HBs titer ("hepatitis B immune globulin") was carried out among 318 new patients and 296 staff members of renal dialysis units. Three milliliters of high titer globulin, repeated at four months, was compared with equal doses of intermediate or normal titer globulin. Among staff members, the cumulative percentages developing hepatitis or HBs Ag, or both, within eight months were 6.9, 11.7, and 11.1 in the high, intermediate, and normal titer groups respectively. The lower incidence associated with high titer globulin was not significant (P greater than 0.05). However, among the patients the respective percentages were 7.9, 21.3, and 23.1 and the lower incidence in the high titer globulin group was significant.

Antibodies↗

A case/control study of the association between primary liver cancer and hepatitis B infection in Senegal.

A case/control study has been carried out to determine by radioimmunoassay and passive hemagglutination techniques the prevalence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) in patients with primary liver cancer (PLC) and age/sex-matched hospital controls with cancers of other sites (OCC) and similarly matched controls without cancer (NCC). HBsAg was found in 61.2% of 165 cases of PLC as compared to 11.7% of 328 NCC. The frequency of HBsAg in PLC patients was significantly higher (72.2%) in those with detectable alpha fetoprotein as compared to those without (40.3%). There was no difference in the frequency of HBsAg in PLC patients with and without accompanying cirrhosis. No significant difference in potential hepatitis exposure history was found in the three study groups.

Adult↗

[Primary liver cancer and hepatitis B infection in Senegal. Comparison of cancer patients with 2 control groups].

A case/control study has been carried out to determine the prevalence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) in patients with primary liver cancer (PLC), and age/sex matched hospital controls with cancers of other sites (OCC) and similarly matched controls without cancer (NCC). HBsAg was found in 61.2% of 165 cases of PLC, as compared to 11.7% of 154 OCC and 11.3% of 328 NCC. The frequency of HBsAg in PLC patients was significantly higher (72.2%) in those with detectable alpha-fetoprotein as compared to those without (40.3%).

Adolescent↗

Can the blood-transmitted hepatitis problem be solved?

Of the approaches presently available for prevention of blood-transmitted hepatitis, most clearly effective is the avoidance of high-risk donor populations, such as most paid commercial donors. It should be emphasized that even after screening for hepatitis B antigen most paid donor blood carries with it a five-ten times higher risk of transmitting hepatitis than volunteer donor blood. Hepatitis B screening is certainly the next most useful approach. However, it has been pointed out that even with the most sensitive of current assays, as much as two-thirds of infective blood may not be eliminated. In part this is due to failure to detect hepatitis B antige, which may be detectable by such currently investigational approaches as selective antibody inhibition or testing for Core antibody. However, a major factor is the inability of hepatitis B screening to eliminate all infectious blood appears to be due to the existence of viruses other than hepatitis B that play a major role in blood-transmitted hepatitis. Tests for detection of carriers of this virus, or viruses, remain to be developed. Improved reporting of hepatitis cases with investigation and registration of implicated donors may provide an additional means for reducing the incidence of hepatitis transmission. The efficiency of additonal approaches, such as transaminase screening of donors and passive or active immunization, remains to be determined.

Animals↗

[Application of a reversed passive hemagglutination test to the detection of HBs antigen].

In this report we present an evaluation of the sensitivity, specificity and ability to detect HBs Ag carriers of a new reversed passive hemagglutination test, using immunochemically purified chimpanzee anti HBs bound to stabilized human erythrocytes. The method was shown to have a sensitivity equal (within one two fold dilution) to that of the Ausria I 125 ratio immuno assay, and in a double blind comparison detected essentially the same number of Hbs Ag containing specimens among volunteer blood donors. The method therefore provides an economical method for the third generation testing of blood donors. The methodology which has been described incorporates a definitive specificity test in which serum drawn before and after immunization of chimpanzees with purified HBs Ag is compared for its ability to neutralize the hemagglutination reaction. The use of serum from the same animal for this purpose avoids the theoretical possibility that antiglobulin antibodies directed at subclass determinants such as Gm of Inv could be differentially inhibited due to possible subclass differences in the blocking sera employed. A reliable test for specificity of HBs Ag screening results is essential to avoid false notification of donors that they are carriers of hepatitis B virus.

Animals↗

Hepatitis B surface antigen in blood donors: further observations.

A survey of 128,000 volunteer blood donors from the Greater New York metropolitan area revealed that first-time male donors were positive for hepatitis B surface antigen (HBsAg) 2.5 times more frequently than were first-time female donors; Negroes and Mongols were positive four to 20 times more frequently than Caucasians. The ratio of ad to ay seemed to be higher in non-Caucasian antigen carriers than in Caucasian carriers. Among both Caucasians and non-Caucasians the rate of positivity declined after the age of 50. An excess prevalence of HBsAg was observed in donors with the lowest level of education and in those with the highest level. HBsAg was detectable nine times less frequently among repeat donors than among first-time donors (0.2 vs.1.90 per 1,000). Detection of HBsAg was unrelated to ABO-Rh blood groups. Several mechanisms for these wide variations of antigen detection are possible.

ABO Blood-Group System↗

Thyroxine binding by hepatitis B surface antigen.

Thyroxine and triiodothyronine binding sites are present on the 20-nm spherical particles associated with hepatitis B surface antigen (HBsAg). Thyroxine-treated HBsAg has a buoyant density of 1.26 g/cm-3 in CsCl and appears under the electron microscope as a hexagonal particle with a center-to-vertex distance of 10 nm. These results provoke questions concerning the origin of thyroid hormone binding sites on HBsAg and a possible relationship between thyroid status and HBsAg antigenemia in humans.

Binding Sites, Antibody↗

Sialyl residues in hepatitis B antigen: their role in determining the life span of the antigen in serum and in eliciting an immunological response.

Hepatitis B surface antigen was adsorbed to insolubilized sialic acid-specific haemagglutinin isolated from the haemolymph of Limulus polyphemus. Treatment of the antigen with Vibrio cholerae neuraminidase (EC 3.2.1.18) resulted in the release of sialic acid and in an increase of the isoelectric point from pH 4-35 (for subtype ad) or 4-9 (for subtype ay) to pH 5-45. Treated, but not untreated, antigen incorporated [14-C]-sialic acid when incubated at 37 degrees C with sialyl transferase (EC 2.4.99.1) and cytidine-5'-monophosphate-[14-C]-sialic acid. The major portion of [14-C]-sialic acid was linked to a glycoprotein with an apparent mol. wt. of 26 x 10-a. De-sialylated antigen had a drastically reduced in vivo life span in rabbit plasma and elicited a higher humoral antibody response than intact antigen (subtype ad). Antigen-stimulated proliferation of lymphocytes, measured 3 months after immunization, was observed only with cells from rabbits injected with neuraminidase-treated antigen.

Adsorption↗

Hydrophobic chromatography of hepatitis B surface antigen on 1,9-diaminononane or 1,10-diaminodecane linked to agarose.

A series of omega-aminoalkyl-agarose differing in the number of carbon atoms in the alkyl chains was prepared and used for chromatography of hepatitis B surface antigen (HBSAg). HBSAg was separated from the major part of serum proteins by adsorption to columns of 1,9-diaminononane or 1,10-diaminodecane linked to agarose beads (Sepharose 4B or 2B) followed by elution with 4 M-NaSCN.

Alkanes↗

A new reversed passive hemagglutination test for detection of HBsAg.

A new reversed passive hemagglutination test for HBsAg, termed Raphadex B, has been developed using immunochemically purified chimpanzee anti-HBs bound to stabilized human erythrocytes. The test has been found to have equivalent sensitivity to the Ausria 125I radioimmunoassay, and detected a similar number of HBsAg-containing specimens in screening of volunteer blood donors. This method offers an economical approach to third generation methodology for hepatitis B screening of blood donors.

ABO Blood-Group System↗

On the role of sexual behavior in the spread of hepatitis B infection.

There is a significant excess of serologic evidence of hepatitis type B infection in two high-promiscuity populations: patients with venereal diseases and their unrelated sexual contacts (15% to 18%) and male, but not female, homosexuals (37% to 51%). Spouses of asymptomatic chronic carriers of antigen had a higher prevalence (26% to 28%) than spouses of noncarriers (10% to 11%); however, the prevalence in the former is relatively low when compared with rates seen in other relatives of carriers. Persons who had a higher-than-average probability of exposure to potentially infective partners or whose patterns of sexual behavior made such exposure more likely (large numbers of sexual partners, long duration of homosexuality, involvement in predominantly anal intercourse) were found to have serologic evidence of hepatitis B more frequently than those with other patterns of sexual behavior. This study showed a strong association between serologic evidence of type B hepatitis and patterns of sexual behavior. However, whether or not transmission of hepatitis type B virus occurs through vaginal intercourse could not be ascertained.

Adult↗