[Hepatitis B as nosocomial infection (aspects of epidemiology and prevention)]. / Gepatit B kak vnutribol'nichnaia infektsiia (voprosy épidemiologii i profilaktiki).

Hepatitis B (HB) was recorded in 1478 (32.3%) of 4577 patients with acute viral hepatitis in Moscow in 1992. Half (50.6%) the patients were infected with HB virus during therapeutical and diagnostic parenteral interventions in 66.1% of them at hospitals, in 7.5% during transfusions of blood and its components (at hospitals too) in the others via natural routes. The HB morbidity per 100,000 patients treated in some Moscow one-profile hospitals sharply differed (74.2 to 89.6 at one hospitals and 5.9 to 7.6% at others). The high HB morbidity at some Moscow hospitals, the group incidence of the disease were associated with the inadequate sterilization quality of medical and laboratory instruments, with the shortage of expendable instruments. The implementation of a complex of measures at individual hospitals, which were aimed at stopping the artificial HB virus transmission routes resulted in 8.2-11.7%-reductions in HB morbidity rates among the patients treated there. In 1990-1992 the HB morbidity among Moscow medical staff was 3.0-3.5-fold than among adults of the city. Surgeons, reanimatologists, and laboratory personnel more frequently fell ill. HB vaccination should be high-priority among this contingent.

[Risk of hepatitis infection of the recipients of blood from donors with HBs-antigenemia]. / Risk zabolevaniia gepatitom retsipientov krovi donorov s HBs-antigenemiei.

Observations were made on 100 recipients of blood from 40 donors with HBs-antigenemia and 106 recipients of the control group, who had received 570 ampules of blood from 491 donors, and 499 ampules from 400 donors, respectively. The incidence of post-transfusion serum hepatitis in the icteric forms was 12.7% and 1.9%, respectively (P less than 0.002), varying between 8.9% and 22.2% in the experimental subgroups, and decreasing with the increase of the total number of blood transfusions received by the subjects. The source of infection proved to be 0.5% of the donors in the control group, and 2.65% in the experimental group (P less than 0.01), or 17.9-33.3%, of donors with HBs-antigenemia. With the sufficient number of recipients traced to each donor, all donors with HBs-antigenemia were found to be the sources of infection. It means that HBs-antigenemia may be regarded as the indication of the presence of the complete (infective) hepatitis virus B in the body.

[Antigen e and its antibodies in acute serum hepatitis and in persons with a prolonged HBs-antigenemia]. / Antigen e i antitela k nemu u bol'nykh ostrym syvorotochnym gepatitom i u lits s dlitel'noi HBs-antigenemiei.

The gel precipitation test was used for examinations of 280 HBsAg-positive patients with jaundiced serum hepatitis and 182 subjects with long-term HBs-antigenemia and various degrees of activity of the pathologic process in the liver, in a coded study. Among the latter, the e-antigen was found in 26.9%, that is twice as frequently than in patients with acute serum hepatitis (14.3%). Particularly frequently (31.1 and 45.2%) the e-antigen was found in children and adults who were assumed to have been the source of SH infection, as well as in infants infected from their mothers during delivery or soon after birth. A certain correlation was found between the rate of detection of the e-antigen and the presence of biochemical changes indicating liver function disorders. Thus, the e-antigen may be a marker of a higher infectivity of the serum and indicate a certain activity of the pathological process. Antibodies to the e-antigen were more frequently found in older age groups and in the absence of biochemical changes in the serum. The e-antigen and antibody to it were detected with similar frequency in infections with subtypes ay and ad of the HBs-antigen.

[Morphological makeup of the structures containing HBsAg in the blood of acute and chronic serum hepatitis patients]. / Morfologicheskii sostav struktur, soderzhashchikh HBsAg v krovi bol'nykh ostrym i khronicheskim syvorotochnym gepatitom.

Immune electron microscopy was used to examine the morphological composition of HBsAg-containing structures in 20 patients with acute serum hepatitis (ASH) and severe accompanying disease in whom HBsAg had been detected by the gel precipitation test for a long time, and in 7 patients with HBsAg-positive chronic active hepatitis (CAH) developing after ASH. Small spherical particles were the predominant form of HBsAg-containing structures in all the sera. Among ASH patients, a significant number of tubular forms and Dane particles were detected mainly in patients with severe accompanying diseases. No correlation between the appearance of a large number of Dane particles and tubural forms and the severity of the disease in ASH was established. In CAH, tubular forms and Dane particles in large numbers were found only in patients with long periods after ASH. Large numbers of Dane particles in all the examined patients were combined with a large number of tubular forms.

[Properties of an infectious agent isolated from the blood of patients with type B hepatitis and donor-antigencarriers]. / Svoistva infektsionnogo agenta, vydelennogo iz krovi bol'nykh gepatitom tipa B i donorov-antigenonositelei

An infectious agent different from HB-Ag was detected in sera from patients with hepatitis B and donors-carriers of HB-Ag. This agent can be passaged for a long time in the human tissue-chick embryo system and has a density of 1.38--1.40 g/ml in cesium chloride gradient.