Leprosy and hepatitis B virus markers: incidence of HBsAg and HBeAg in Somalian patients.

Serum samples from 222 Somalian patients, 135 with the lepromatous form of leprosy and 87 with the tuberculoid form of the disease, were examined for the presence of the surface antigen (HBsAg), the "e" antigen (HBeAg), and their corresponding antibodies (anti-HBs and anti-e). HBsAg was present in 24.4% of the LL cases and in 11.5% of the TT patients while anti-HBs was found respectively in 46.6% and 58.6%. The e-antigen was not found in any case of leprosy; anti-e was detected in 8.1% of the LL patients and in 3.5% of the TT cases. The rate of HBV seropositivity (HBsAg plus anti-HBs) was the same in the LL patients (71.1%) and in the TT patients (70.1%) and that could reflect the conditions of life in their closed community. The analysis of results obtained in Somalia has shown the presence of a difference in the distribution of HBsAg among leprosy patients, with an increased antigenemia in the lepromatous form which was statistically significant (p less than 0.05). No differences, however, were found between the leprosy patients and healthy controls. These observations seem to indicate that patients with lepromatous leprosy do not have an increased susceptibility to infection by hepatitis B virus.

The surface antigen (HBsAg) and the e-antigen (HBeAg) in Somalian patients with acute viral hepatitis.

Serum samples from 55 Somalian patients with acute viral hepatitis were examined for the presence of the surface antigen (HBsAG) and the e-antigen (HBeAg) and the corresponding antibodies (anti-HBs and anti-e). No e-antigen was detected in patients with viral hepatitis or in controls (47 cases); anti-e was found in 23.6% of hepatitis cases, all of whom were HBsAg carriers, and in 10% of the controls. The HBsAg was found in 60% of cases with hepatitis and 34% of controls; the anti-HBs was detected in 18% of the patients with hepatitis, all except one of whom were negative for HBsAg; in the one exception the HBsAg and anti-HBs were present simultaneously; the anti-HBs was found in 44.6% of controls. The frequency of serological evidence of hepatitis B infection (HBV) based on the presence of antigen/antibody HBs was 78.2% among patients with acute viral hepatitis; only 30% of these patients showed evidence of anti-e antibody.

[E antigen (HBeAG) and surface antigen (HBsAg) in bladder schistosomiasis]. / L'antigene "e" (HBeAg) e l'antigene di superficie (HBsAg) nella Schistosomiasi vescicale.

The problem of the relationship between surface B antigen and schistosomiasis or other parasitic infections which are transmitted though the skin is not still resolved. Serum samples from 54 Somalian patients infected by Schistosoma haematobium were tested for the presence of the surface B antigen (HBsAg) and the e-antigen (HBeAg). The HbsAg was found in 14.8 per cent of these patients, while among controls (47 cases) the frequency was of 34.0 p]er cent; no e-antigen was found among the patients and controls, the prevalence of anti-HBs antibodies was of 57.4 per cent among the patients with urinary schistosomiasis and of 44.6 per cent among the controls; a low rate of anti-e antibodies was found in the patients (7.4%) and in the controls (10.6%). These observation seem to indicate that the problem of an increased frequency of hepatitis B virus markers among patients with urinary schistosomiasis needs for further investigation.

E antigen in the serum of HBs antigen-positive patients on maintenance dialysis and after transplantation.

The 'e antigen' (eAg) is specifically associated with hepatitis B virus infections and appears to be a marker for the infectivity and a prognostic indicator of the chronicity of liver disease. Therefore we examined by immunodiffusion the presence of eAg in the seum of HBsAg-positive patients on maintenance dialysis. The dialysis patients had a significantly higher incidence of positive eAg compared with a group of unselected HBsAg-positive patients without renal failure. In most of the dialysis patients the microscopic findings in the liver revealed only 'minimal changes'. Three eAg-positive patients received a renal transplant. Afterwards they displayed an appreciably increased eAg-yield on immunodiffusion and histology revealed chronic persistent hepatitis. It is assumed therefore that the immunodeficiency of patients undergoing chronic haemodialysis is possibly a supporting factor in the synthesis of eAg, and will perhaps induce a more subscute and prolonged course of hepatitis. The synthesis of eAg after renal transplantation may be enhanced by the additional immunosuppressive therapy.

[The "e" antigen (HBeAg) in leprosy]. / L'antigene "e" (HBeAg) nella lebbra.

Sixty-six sera from leprosy patients, 42 with lepromatous leprosy (l.l.) and 24 with tuberculoid leprosy (t.l.) were examinated for the presence of e-antigen and e-antibody by immunodiffusion. The test for e-antigen was negative in all leprosy patients; e-antibodies were found in only three patients (4.5%) with l.l., all carriers of hepatitis B antigen. The HBsAg test was positive in 23.8% of the l.l. cases and in 12.5% of the t.l. cases; the anti-HBs was present in 38.1% of the l.l. cases and in 41.6% of the t.l. cases. The results suggest the possibility that the leprosy patients positive for the surface B antigen represent a very low risk and can be considered as chronic asymptomatic carriers of HBsAg.

[Contact lens-fitting, a hepatitis risk? (author's transl)]. / Kontaktlinsenanpassung: Ein Hepatitisrisiko?

Hepatitis-B-antigen has been demonstrated by the radioimmunologic method in 5 out of 40 patients with acute or chronic HBs-antigen-positive hepatic disease. The importance of this finding as to the transferral of hepatitis by the fitting of contact lenses and its consequences are discussed.

Antibodies against the hepatitis B surface antigen in diabetics.

The frequency of antibodies to the hepatitis B surface antigen was determined in 406 diabetics in two study series separated in time (1971-1972 and 1974-1975). In the 1971-1972 series, the antibody frequency in insulin and orally treated patients was significantly higher, and the incidence of hepatitis was also greater. The decline in the antibody frequency in the 1974-1975 series is primarily attributed to improved hygienic measures. Anti-HBs was more frequently demonstrable in insulin-dependent diabetics than in orally treated patients. Since the duration of diabetes was about three times as long in this treatment group and the frequency of metabolic checks twice as great, the raised antibody frequency in insulin-injecting diabetics was attributed to greater exposure to the virus.

[Epidemiolgical significance of HBs-antigen subtypes D and Y in the Heidelberg area]. / Die epidemiologische Bedeutung der HBs-Antigen-Subtypen D und Y im Raum Heidelberg

The HGsantigen subtypes D and Y were determined radioimmunologically in 220 HGsAg-positive patients from the Heidelberg area. The subtype D was significantly more frequent (D = 68%) in patients with chronic liver diseases (n = 45) and in healthy HGsAg carriers (n = 32) than in patients with acute viral hepatitis B (n = 143, D = 41%). The subtype distribution in patients with acute viral hepatitis was not constant in the years 1970--1974. An antigen drift from subtype D to subtype Y was shown in healthy HBsAg carriers from 1971 to 1974. The differing distribution of subtypes in persons with transient and persistent HGsAg finding can be explained unequivocally by the altered epidemiological situation at the time of the infection.

A radioimmunoassay to determine the subtypes D and Y of the hepatitis-B surface antigen.

A radioimmunologic test system for determining the subtypes D and Y of the hepatitis-B surface antigen (HBs-Ag, Australia antigen, HAA) is described. This technique uses the immunoadsorption principle. The antigen to be subtyped is incubated with an antiserum which contains (125)I-labeled antibodies to the antigenic determinants a, d, and y. The specificity of the antibody which is not consumed in forming the antigen-antibody complex is determined by absorption on agarose to which HBs-Ag of subtypes D and Y is coupled. This specificity permits conclusions as to the subtype of the hepatitis-B surface antigen which is being investigated.