Membranous nephropathy following perinatal transmission of hepatitis B virus infection--long-term follow-up study.

In children with hepatitis B-associated membranous glomerulonephritis, the time of onset of the infection and the duration of the carrier state before diagnosis of the renal disease are always unknown. Moreover, follow-up is usually short. We report the unique observation of a French girl who was infected with hepatitis B virus by her mother who had acute hepatitis during the immediate postpartum period; the girl developed proteinuria at 6 years of age. The onset of the infection in the perinatal period, the mild liver abnormalities, and the absence of nephrotic syndrome did not justify any treatment. Spontaneous seroconversion to anti-HBe antibody positive occurred at 12 years of age. Proteinuria gradually diminished and was absent at 18 years. However, HBs antigenemia persists.

Study of hepatic functions and prevalence of hepatitis-B surface antigenaemia in Omani children with sickle cell disease.

The prevalence of persistent hepatitis-B surface (HBS) antigenaemia and hepatic functions have been determined in 125 children with sickle cell disease (SCD) as well as in 100 age-matched healthy children. Hepatic functions and the presence of HBS antigenaemia have been followed for 1 year in six children with SCD and 10 normal children following acute hepatitis-B infection. The prevalence of chronic HBS antigenaemia (3 per cent) in children with SCD is not higher than in normal children (11 per cent). The significant elevation of serum alanine transferase (ALT) and bilirubin concentrations in sickle cell children denotes a process of mild hepatocellular dysfunction which is unrelated to hepatitis-B viral antigenaemia. The high incidence of chronic HBS antigenaemia accompanied by elevated serum ALT and bilirubin concentrations in sickle cell children following acute hepatitis-B infection, in addition to the significant impairment of hepatic functions in sicklers with chronic HBS antigenaemia compared to those without the antigenaemia, point out to the high risk of continual parenchymal hepatic damage in these children following acute hepatitis-B infection. Vaccination against hepatitis-B virus should eliminate this risk.

HBsAg in urine: a new approach for the detection of urinary antigens.

In order to define the optimal conditions for detection of microbial antigens in urine, urinary HBsAg excreted during hepatitis B was chosen as a model. Using commercial kits, which mainly involve anti-discontinuous epitopes, we found urinary HBsAg in only 50% of patients with HBsAg in their sera. In contrast, with an inhibition method involving a monoclonal antibody recognizing a continuous epitope, urinary HBsAg was found in 100% of these patients. Structural analysis of HBsAg showed that urinary HBsAg is denatured; it can escape detection by commercial kits well fitted for detection of native serum HBsAg. General implications for the revelation of urinary microbial antigens are discussed.

Detection of markers of hepatitis B virus infection in urine of chronic carriers.

Urine from 19 chronic hepatitis B virus (HBV) carriers was tested for markers of HBV infection. Hepatitis B surface and e antigens were excreted in the urine of about one-half of the patients, but not in any consistent pattern. HBV DNA, a much more sensitive indicator of infectivity, was found in only one specimen and then in very low concentration. We conclude that urine of chronic HBV carriers is not a major vehicle for the transmission of hepatitis B.

[HBsAG in feces, urine and saliva]. / Ricerca dell'HBsAG nelle feci, urine, saliva.

After some observations about the tests of the research exposed in the literature, authors illustrate the tests for 142 patients divided into 5 groups: a) patients affected with acute viral hepatitis; b) patients affected with praegressa acute viral hepatitis; c) relatives of patients with acute viral hepatitis; d) volunteers; e) patients affected with chronic uraemia under dialisis periodic treatment. After the testing control, authors, conclude with an hipotesis: a possible epidemic function of faeces, urine saliva, in the passage of the acute viral hepatitis.

Hepatitis B surface antigen in urine of hemodialysis patients.

As part of an extensive epidemiological survey of chronic hemodialysis patients in Michigan, hepatitis B surface antigen (HBsAg) was identified in the sera of 79 of 701 (11%) patients. Of these patients, 59 were carriers of HBsAg for three or more months. Urine samples were collected from 36 of 39 HBsAg carriers having urinary output. Of these samples, 19 (52%) were positive for HBsAg by radioimmunoassay; this was confirmed by specific antibody neutralization. The HBsAg was not identified in the urine of seven hemodialysis patients who were lacking serum HBsAg or in urine samples from three HBsAg sero-carriers who had normal renal function. Patients undergoing maintenance hemodialysis appear to constitute a large reservoir of HBsAg chronic carriers. This study indicates that a minimum of 50% of persistent HBsAg carriers who are producing urine have detectable HBsAg in single, randomly timed, unconcentrated urine specimen. These data suggest that urine may represent a potential vehicle for transmission in nonparenterally acquired hepatitis B.