Prevalence and significance of hepatitis B surface antigen in a general hospital.

Over a 6-month period 2025 patients admitted to New Mount Sinai Hospital, Toronto were screened for hepatitis B surface antigen (HBsAg) by counter-immunoelectrophoresis (CIEP) and radioimmunoassay (RIA). CIEP detected 12 HBsAg-positive patients and RIA 16. RIA is therefore the more sensitive test for HBsAg. Of the 16 patients 2 had liver disease previously diagnosed, 3 had malignant disease and 11 were asymptomatic carriers. Of the 11 carriers all were born in countries where the carrier rate is known to be high. Routine screening of hospital patients on admission is of no value in detecting unsuspected liver disease but is of value in detecting asymptomatic carriers, which is of importance for the patient and his family. Routine screening tests for HBsAg in Canadian hospitals that treat many patients born in countries with a known high HBsAg prevalence is recommended. Routine screening is also recommended in all hospitals in Mediterranean and Asian countries.     

Frequency of hepatitis B antigen in blood donors

Routine testing of all blood donations for hepatitis B antigen by counter-immunoelectrophoresis was started in April 1971. The frequency of HBAg carriers among apparently healthy volunteer blood donors in the Toronto Centre of the Canadian Red Cross Blood Transfusion Service was 15 in 10,000 with a male:female ratio of 6:1. Excluding penitentiary inmates, the highest incidence was among young, male, non-Anglo-Saxon city dwellers.A system of notification of HBAg-positive donors was developed, through which a carrier is referred to a special clinic for clinical and pathological evaluation.A survey of hospital patients indicated an incidence of HB antigen 3.5 times that of our healthy donor population. A comparison of the number of post-transfusion hepatitis cases occurring before and after the commencement of routine testing for HBAg showed a marked reduction in reported cases in 1971.     

Screening for circulating immune complexes in blood donors as an effective method of further HBsAg carriers detection

The loss of counterimmunoelectrophoretic (CIEP) HBsAg reactivity resulting from circulating immune complexes (CIC) formation, observed earlier, prompted us to evaluation the CIC screening in blood donors as an aid in HBsAg detecting. CIC were examined by means of a simple screening modification of the Pegikem test. Among 2.150 normal blood donors there were 21 (0.98%) CIC carriers found, in 13 (61.90%) of them HBsAg was then proved by means of a third generation test. In this population, CIC presence indicated twice as many HBsAg carriers as the CIEP. HBsAg is evidently a very important source of CIC in normal population. The CIC presence is supposed to be a good indicator of HBsAg as well. Therefore, before being accepted as blood donors, CIC carriers should be tested by sensitive test for HBsAg presence.     

Screening of Danish blood donors for hepatitis B surface antigen using a third generation technique.

The profit to be gained by testing Danish blood donors for hepatitis B surface antigen (HBsAg) with a third generation technique instead of the currently used immunoelectrophoresis was investigated by additional screening of 48 750 blood units by radioimmunoassay three weeks after donation. Twenty nine units were positive for HBsAg on radioimmunoassay (0.059%). Only six of these were found by immunoelectrophoresis (0.012%). Most of the 23 donors positive on radioimmunoassay and negative on immunoelectrophoresis were healthy carriers of HBsAg (20) or had asymptomatic chronic liver disease (two). One donor had acute hepatitis B. Fifteen of the 23 blood units were transfused. The 15 recipients were monitored biochemically and serologically for up to nine months. One recipient developed fulminant hepatitis B, three developed acute hepatitis B, and one became a healthy carrier of HBsAg. All these patients had received blood from healthy carriers of HBsAg. Two recipients were immunised against HBsAg, and in one patient no seroconversion was observed. The remaining recipients died soon after transfusion or were protected by antibodies to HBsAg that had been present before the transfusion. Testing of Danish blood donors using a third generation technique identified a substantial number of donors positive for HBsAg overlooked by immunoelectrophoresis. Most of these donors were healthy carriers of HBsAg. Blood taken from such carriers is highly infectious when transfused, probably because of the large amount of material transmitted.     

Hepatitis B antigen: distribution of ad and ay subtypes in blood donors and hepatitis patients

Hepatitis B antigen (HBAg) from blood donors and patients with hepatitis was tested for ad and ay subspecificity by immunodiffusion in agarose. A total of 59 sera from blood donors and 81 sera from hepatitis patients were subtyped.Subtyping of HBAg from blood donors showed ad and ay subspecificity in 64.4 and 35.6% of cases respectively. Patients'' sera on the other hand showed HBAg with ad and ay subspecificity in 6 and 94% of cases respectively. Therefore, ad subtype was more frequently associated with blood donors whereas ay subtype was predominant among hepatitis patients. The relationship between clinical findings and HBAg subtype is also discussed.     

Hepatitis B virus DNA and e antigen in serum from blood donors in the United Kingdom positive for hepatitis B surface antigen.

Serum samples from 214 blood donors in the United Kingdom who were carriers of hepatitis B surface antigen (HBsAg) were examined for hepatitis B virus deoxyribonucleic acid (DNA) by DNA:DNA hybridisation and for hepatitis B e antigen (HBeAg) and its antibody. One fifth of the donors carried infectious virus in their circulation. The presence of hepatitis B virus DNA correlated well with that of HBeAg, although hepatitis B virus DNA was found in five serum samples that were negative for HBeAg. It is concluded that analysis of serum samples for hepatitis B virus DNA by hybridisation should be the method of choice for determining whether carriers of HBsAg are infectious.     

Determination of antibody to hepatitis B core antigen by means of immune adherence hemagglutination.

A simple and rapid method utilizing immune adherence hemagglutination has been developed for the detection of antibodies to hepatitis B core antigen (anti-HBc). Hepatitis B core antigen (HBcAG) was prepared from Dane particles that had been isolated from plasma of asymptomatic antigen carriers. The method was specific and about 10 times more sensitive than the conventional complement-fixation method. A total of 215 serum samples obtained from healthy blood donors were surveyed for HBsAG and anti-HEc, as well as for hepatitis B surface antigen (HBsAg) and antibody to HBsAG (anti-HBs). Anti-HBc was found in 36 serum samples, at a prevalence rate higher than that of anti-HBs (31/215)...     

基于UPLC-QTOFMS正、负离子模式对无偿献血者乙型肝炎表面抗原阳性血清代谢组学的研究

目的:基于超高效液相色谱-单四极杆飞行时间质谱(UPLC-QTOFMS)正、负离子模式探讨无偿献血者中乙型肝炎表面抗原阳性和乙型肝炎表面抗原阴性的血清代谢组学的差异,为乙型肝炎的诊断寻找潜在的血清生物标志物。方法:选取2017年10月~2018年1月在青海省血液中心检测的乙型肝炎表面抗原阳性57例(研究组)与同期无偿献血者乙型肝炎表面抗原阴性63例(对照组),利用UPLC-QTOFMS技术建立两组血清代谢指纹图谱,采用主成分分析(PCA)和偏最小二乘法-判别分析(PLS-DA)分析两组间有差异的小分子物质,确定与乙型肝炎相关的生物标志物,并分析相关代谢机制。结果:通过变量重要性投影、质谱鉴定和数据库检索筛选出8个潜在的生物标志物,分别为缬氨酸、胆碱、甘氨鹅去氧胆酸、肉毒碱、高丝氨酸、溶血磷脂酰胆碱、血清溶菌酶和花生四烯酸,涉及胆汁酸代谢、氨基酸代谢、磷脂代谢等。结论:无偿献血者中乙型肝炎表面抗原阳性和乙型肝炎表面抗原阴性的血清代谢物存在显著差异,差异代谢物的发现有助于寻找乙型肝炎的潜在生物标志物,为血液安全提供依据。     

Detection of Hepatitis B Antigen by Counter-Immunoelectrophoresis: Enhancing Role of Homologous Serum Diluents

Dilution of hyperimmune hepatitis type B antibody in undiluted homologous species normal serum has resulted in enhanced sensitivity for detecting hepatitis B antigen by a discontinuous counter-immunoelectrophoresis method compared to hepatitis type B antibody diluted in heterologous species normal serum or buffer solutions.     

Occurrence of non-A, non-B post-transfusion hepatitis in heart surgery. Prospective study on the value of the determination of serum alanine aminotransferase and detection of anti-HBc antibodies in blood donors

We studied a group of 64 patients undergoing cardiac surgery for the occurrence of post-transfusion hepatitis during a follow-up period of 5 months. They received blood units (packed red cells in saline-adenine-glucose medium and/or fresh frozen plasma exclusively) from 447 volunteer donors. Post-transfusion hepatitis was identified in 5 patients: 1 patient had cytomegalovirus hepatitis and the remaining 4 cases were defined, by exclusion, as non-A, non-B hepatitis (with prevalence and incidence rates of 80% and 6.25% respectively). We found no statistically significant differences between the numbers of transfused blood product units in patients who developed non-A, non-B hepatitis as compared to those who did not. Our analysis of the predictive effectiveness of alanine aminotransferase and anti-HBc antibodies screening in blood donors to prevent non-A, non-B post-transfusion hepatitis led to the following conclusions: we failed to confirm the association between anti-HBc in blood donors and enhanced risk of non-A, non-B hepatitis in recipients since no case developed among patients receiving blood products from anti-HBc positive donors. So, 20 donors (4.5%) would have been discarded without any reduction of the incidence of non-A, non-B hepatitis. we could not confirm nor exclude the possibility that screening donor blood for elevated alanine aminotransferase levels would have reduced the number of non-A, non-B hepatitis in recipients.     

Difference in the distribution of e antigen among different ethnic groups in a population of blood donors.

Sensitive techniques were used to detect e antigen and the corresponding antibody (anti-e) among 368 voluntary blood donors positive for hepatitis B surface antigen in the Montreal area and 310 people living in close contact with them. Neither e nor anti-e was found in the absence of markers of hepatitis B virus (HBV). Among the blood donors e antigen was detected in 23 and anti-e in 313, and 32 were negative for both markers. Of the 368 blood donors 330 were of French origin and 38 from other ethnic groups. The 23 e-positive subjects were unequally distributed among the ethnic groups: only 14 (4.2%) were recruited among the French group while 9 (23.7%) were recruited among other ethnic groups (P less than 0.001). This differences among ethnic groups might be related to the vertical or horizontal mode of dissemination of HBV infection.     

Subtypes of Hepatitis B Antigen in Blood Donors and Post-transfusion Hepatitis: Clinical and Epidemiological Aspects

Subtyping of hepatitis B antigen (HBA) in blood donors revealed subtype ad in 56% while patients with icteric post-transfusion hepatitis from the same centre showed subtype ay in the majority of the cases (75%). Donors with subtype ad in serum were mostly asymptomatic long-term carriers of the antigen with normal liver function (83%), while 70% of donors with subtype ay in serum had signs of acute or chronic liver disease. Healthy long-term carriers of HBA seem to present little risk of transmitting hepatitis irrespective of subtype. It is, however, possible that these differences in blood donors with subtype ad and patients with post-transfusion hepatitis with subtype ay might reflect epidemiological circumstances rather than biological differences in the two viral strains.     

Induction of Hepatitis B Antibody in Experimental Animals by Immunization with A-2 Plaque Virus

A sero-conversion for hepatitis B antibody has resulted from immunization of patas monkeys, guinea pigs, and rabbits with the A-2 plaque virus. This agent was isolated in tissue culture from patient sera that were positive for hepatitis B antigen. The immune response was assayed with techniques of direct and indirect counter-immunoelectrophoresis, and immune electron microscopy.     

Prevalence of antibodies to hepatitis B core antigen in blood donors in the middle West region of Brazil

The prevalence of antibodies to hepatitis B core antigen in 552 prime blood donors was of 9.4%. The majority (71.2%) has antibodies to hepatitis B surface antigen. The hepatitis B surface antigen was present in 0.7%, all of them antibodies to hepatitis B core antigen positive.     

Post-transfusion hepatitis. Sudden drop of its incidence associated with hyperbilirubinemic donors disqualification

The lacking impact of various precautions on the incidence of post-transfusion hepatitis (PTH) in the last 15 years is presented. In 1984, however, PTH dropped from 0.12 to 0.04%. This PTH drop did not coincide with the disqualification of HBsAg carriers, nor with that of high ALT, nor with the introduction of complete voluntary donorship in 1982, but with the systematic exclusion of hyperbilirubinemic donors. Circulating immune complexes (CIC) were found in 28.9% of PTH compromised donors, and CIC are therefore supposed to be a marker of PTH risk even if HBsAg was not demonstrable. Re-examining donors compromised in 120 PTH found 12.4% HBsAg carriers who had not been detected by CIEP prior to the transfusions. Accumulation of more than one HBsAg positive transfusion in 56.5% of the PTH patients suggests a cumulative effect. The inability of specific tests to identify sources of infection in 50% of PTH suggests that doubts must be raised as to their post-transfusional origin. This thesis is also supported by the relative increase of this group after the considerable drop of PTH. The importance of viral sources non-B and B undetectable by sensitive specific methods must be emphasized. The latter is in accordance with the observed PTH drop due to a non-specific marker effect. The bilirubin level screening in each donor before stored blood collection is recommended by means of the described extended AST screening test and, besides HBsAg screening, this is supposed to be the most effective precaution for preventing PTH.     

Presence of lower temperature-dependent antibody with low avidity to C100-3 (HCV) antigen in voluntary blood donors.

Serum samples with lower temperature-dependent antibody with low avidity to C100-3 (HCV) antigen were found in 0.19% of 23,197 voluntary blood donors at this blood center. They showed positive C100-3 antibody activity at 24 C but not at 37 C. The antibody activity bound to C100-3 antigen at lower temperature disappeared after incubation for 60 min at 37 C or treatment with 8 M urea. Other markers of hepatitis C virus infection, especially the presence of HCV-RNA were demonstrated in some of these serum samples and the importance of this phenomenon is discussed with regard to virus screening of blood donors for hepatitis C.     

Physico-chemical and antigenic characterization of unconventional heavy chain antibodies of Indian desert camel (Camelus dromedarius L.)

Heavy chain antibodies (HCAbs) of IgG2 and IgG3 subtypes were purified from the sera of Indian desert camel (Camelus dromedarius L.) by ammonium sulphate precipitation, followed by ion-exchange chromatography on DEAE-cellulose and affinity chromatography on protein A-sepharose and protein G-sepharose, and characterized by SDS-polyacrylamide gel electrophoresis, agar gel immunodiffusion (AGID), counter-immunoelectrophoresis (CIEP), immunoelectrophoresis (IEP), ELISA and immunoblotting. IgG2 and IgG3 were found to have molecular mass 46.77 kDa and 43.65 kDa, respectively by SDS-PAGE under reducing conditions. They migrated in beta-region in IEP and could be detected in CIEP, because of being more negatively charged and smaller size. Anti-camel IgG3 cross-reacted in AGID, ELISA and immunoblotting with IgGs of pig and ruminants (cattle, buffalo, sheep and goat), but not with immunoglobulins from horse, dog, guinea pigs, mice, fish, poultry and human. The present findings suggest close antigenic relationship of camels with pigs and ruminants.     

Prevalence of HBsAg and HBsAg sub-types in the Canadian blood-donor population

After 8 years of screening all blood donations in Canada for HBsAg, first by CIEP and later by RIA, the prevalence of HBsAg in the regular panel of "repeat" donors has been reduced from 267/10(5) to 39/10(5). Marked geographic variations exist, but the available data do not indicate whether the high prevalence of HBsAg in young adults, particularly males, may be a factor. The ad : ay subtype ratio across Canada is 2.0, but noticeable geographic differences are present, varying from 3.5 in Quebec to 0.5 in the Atlantic Provinces.     

Evaluation of two enzyme-linked immunosorbent assays for serodiagnosis of Aleutian mink disease virus infection in mink

Background

Aleutian disease in mink is caused by infection with Aleutian mink disease virus (AMDV). In Sweden, the infection most commonly causes classical Aleutian disease in which the immune system fails to neutralize the virus and the infection becomes persistent. Diagnosis of AMDV infection is based on serological methods that detect virus-specific antibodies. Traditionally counterimmunoelectrophoresis (CIEP) has been the preferred method, but in order to enable automation interest has been paid to other antibody detecting systems. Recently, at least two different ELISA systems that detect antibodies to AMDV have been manufactured; one is based on an in vitro grown AMDV as antigen, and the other system is based on the AMDV capsid protein VP2 as antigen. The aim of this study was to evaluate the two ELISA systems for detection of antibodies to AMDV using CIEP as the gold standard.

Results

When employing the mean optical density of the samples from CIEP negative mink plus three standard deviations as cut-off value, the ELISA with the VP2 antigen had a sensitivity of 99.7% and a specificity of 98.3% compared to CIEP (n?=?364). Analysis of samples with the AMDV-G antigen based ELISA employing an assay cut-off value based on the negative control samples, as suggested by the manufacturer, resulted in a sensitivity of 54.3% and a specificity of 93.2% with reference to CIEP as the gold standard (n?=?359). When employing the mean optical density of the samples from CIEP negative mink plus three standard deviations as cut-off value, the AMDV-G ELISA had a sensitivity of 37.6% and a specificity of 98.3%.

Conclusions

The ELISA system based on VP2 antigen had high sensitivity and specificity, and was concluded to be an alternative to the CIEP as a diagnostic tool for AMDV antibodies. In contrast, the AMDV-G ELISA suffered from low sensitivity when compared to CIEP.

     

Total Screening of Blood Donations for Australia (Hepatitis Associated) Antigen and its Antibody

During a period of one year all of 105,724 blood donations were tested for Australia (Au) antigen and its antibody by rapid immunoelectro-osmophoresis—86 (1 in 1,229) were positive for antigen and 67 (1 in 1,578) positive for antibody. Second donations by previously negative donors reduce the overall incidence of positives. Men prisoners have a significantly higher incidence of Au antigen (1 in 153) than non-institutionalized men (1 in 803). The latter have a significantly higher incidence of antigen than women (1 in 2,019). Only one antigen-positive donor was incubating acute viral hepatitis. Failure to detect one strong and one weak antigen was responsible for two cases of posttransfusion Au-antigen-positive hepatitis.