B.S. Blumberg

EFFECT OF PHYLLANTHUS AMARUS ON CHRONIC CARRIERS OF HEPATITIS B VIRUS

In a preliminary study, carriers of hepatitis B virus were treated with a preparation of the plant Phyllanthus amarus for 30 days. 22 of 37 (59%) treated patients had lost hepatitis B surface antigen when tested 15-20 days after the end of the treatment compared with only 1 of 23 (4%) placebo-treated controls. Some subjects have been followed for up to 9 months. In no case has the surface antigen returned. Clinical observation revealed few or no toxic effects. The encouraging results of this preliminary study recommend continued evaluation of this plant and the active principles isolated from it.

HOST RESPONSES TO HEPATITIS-B INFECTION IN PATIENTS WITH PRIMARY HEPATIC CARCINOMA AND THEIR FAMILIES: A Case/Control Study in Senegal, West Africa

A case/control study of patients with primary hepatic carcinoma (P.H.C.) and their families was carried out in Dakar, Senegal. 28 P.H.C. cases were matched by age,sex, and ethnic group with 28 controls. Serum was collected from cases, controls, parents (28 mothers, 27 fathers) of cases, parents of controls, 71 siblings of cases, and 58 siblings of controls. Assays of their sera for hepatitis-B surface antigen (HBsAg), antibody to HBsAg (anti-HBs) and antibody to hepatitis-B core antigen (anti-HBc) produced the following results. (1) Nearly all P.H.C. cases (97%) and controls (93%) had some evidence of infection with hepatitis-B virus (H.B.V.), but the cases were more likely to be anti-HBc(+) and less likely to be anti-HBs(+) than the controls. (2) Most of the mothers of the cases were HBsAg(+) (71%), whereas only 14% of the mothers of controls were HBsAg(+). Lover titres of anti-HBs were less common in the mothers of the cases. (3) None of 27 fathers of cases had detectable anti-HBs, but 13 (48%) of the fathers of controls were anti-HBs(+). (4) Siblings of the P.H.C. cases were more likely to have anti-HBs than either their sibs with P.H.C. or the sibs of the controls. However, sibs of P.H.C. cases had lower titres of anti-HBs than the sibs of the controls. These data are consistent with the hypothesis that the P.H.C. cases were infected with H.B.V. by their mothers and that there was an environmental factor which affected the immunological response of all family members to H.B.V. Infection with H.B.V. and the mode of response to that infection among members of families appear to be major factors in the aetiology of P.H.C. in West Africa.

ANTIBODY TO HEPATITIS-B CORE ANTIGEN IN PATIENTS WITH PRIMARY HEPATIC CARCINOMA

Antibody to hepatitis-B core antigen (anti-HBc) was assayed in the serum of patients with primary hepatic carcinoma (P.H.C.) and controls from Hong Kong, West Africa, and the United States. In each region the prevalence of anti-HBc was higher in P.H.C. patients than in controls, ranging from 70 to 95% in the patients and from 20 to 68% in the controls from Asia and Africa; 24% of P.H.C. patients and 4% of controls from the U.S. had anti-HBc. These data support the hypothesis that chronic infection with hepatitis-B virus is aetiologically related to P.H.C., especially in Asia and Africa, although other factors must also be involved.

Hepatitis-B virus in bedbugs (Cimex hemipterus) from Senegal.

Bedbugs of the species Cimex hemipterus (F) were collected on four separate occasions from the bedding in the huts of village dwellers in Senegal, West Africa. Hepatitis-B surface antigen (HBSAg) was detected in unengorged nymph and adult bedbugs in each of the first three collections. 3 of 28 such specimens were HBSAg(+) in the first collection and 3 of 17 specimens were positive in the second collection. In the third, 6 of 9 were HBSAg(+) when the bed occupant was known to be HBSAg(+). 2 of these 6 positive insects did not contain human serum proteins. Bedbugs in the fourth collection were captured and kept alive without a blood meal for 30 days. 3 of 89 of these samples were HBSAg(+). These are the highest field infection-rates of hepatitis-B virus reported in any insect species. The bedbug must be considered a potential vector of hepatitis-B virus.

Specificities of Human Antibodies to Australia Antigen

Summary Nine different human anti-Australia antigen antisera were compared to each other using population and immunologic methods. Six of the antisera fell into the same category (Philadelphia I) and included specificities detected by the previously described anti-Au(1) antisera. There were three antisera, each of which contained specificities different from those in the anti-Au(1) category. They are to be examined to see whether they identify forms of hepatitis or other conditions different from those detected by anti-Au(1).

Detection of Australia antigen in human tissue culture preparations.

Summary An attempt was made to propagate Australia antigen. Au(1), in tissue culture. The approach to the study was twofold: (a) the culturing of fresh biopsied tissues from patients with hepatitis and Au(1) in their blood; and (b) the addition of serum, plasma, and extracts of biopsied liver from patients with Au(1) in their blood to established cell lines and primary cells from human fetal tissues in tissue culture. Positive results were obtained only with the first approach. Two liver cultures out of 23 specimens from patients with Au(1) in their blood produced either intranuclear fluorescent granules after staining with fluorescent coupled rabbit anti-Au(1) antiserum or Au(1) in the tissue culture fluids as determined by a sensitive radio-immunoprecipitation assay technique. Fluorescent intranuclear granulation appeared during the second and sixth passage of one culture of liver. It is unlikely that this could be explained by carry-over of Au(1) from the initial biopsy specimen. Cultures of sternal bone marrow, testis, jejunal loop, and lymphocytes from patients who had Au(1) in their blood were uniformly negative for fluorescent granules as well as Au(1) by radioimmuno-precipitation assay. The results indicate a strong possibility that Au(1) replicates in tissue culture.

A NEW PRECIPITATING ANTIGEN-ANTIBODY SYSTEM (PENNSYLVANIA ANTIGEN) IN HUMAN SERUM

Abstract A new precipitin system is reported. The precipitating antibodies are directed against a rare serum-antigen system termed tentatively Pennsylvania antigen (Pe). It has been detected in 0.35 % of 2846 sera tested. The antibodies were found in the sera of 18% of 302 Downs syndrome patients and in 4 of 22 patients with chromosome anomalies other than Downs syndrome. With the exception of 2 cases, they were not found in the sera of a variety of healthy and diseased individuals. The Pe antigen is almost entirely restricted to patients affected with haematological disorders, including leukaemia, thalassaemia, and Fanconis anaemia. It was also detected in the cord blood of a newborn baby with Downs syndrome, one human fœtal serum, cows milk, and foetal and newborn calf serum. The antigen differs from known human foetal and adult serum-proteins. Two serological specificities have been shown in some of the Pe(+) sera.

INCIDENCE OF ANTIBODIES AGAINST β-LIPOPROTEINS (Ag SYSTEM), AND THE FACTORS INFLUENCING ISOIMMUNISATION IN TRANSFUSED PATIENTS IN THE U.S.A. AND ITALY

Abstract The sera from transfused U.S. and Italian Summary thalassaemic children, and U.S. non-thalassaemic patients were examined for the presence of anti-β-lipoprotein (Ag) isoprecipitins. Anti-Ag antibodies were detected in 29.8% of U.S. thalassaemic children, in 12.7% of Italian thalassaemic children, and in only 3.9% of U.S. non-thalassaemic patients. The distribution of Ag(a 1 ), Ag(x), and Ag(y) groups and the quantity of β-lipoprotein in the donors and transfused patients did not explain the differences in sensitisation. The variation in production of anti-Ag isoprecipitins in U.S. and Italian thalassaemic children may be caused by differences in treatment (splenectomy and frequency of blood-transfusions). Children with thalassaemia develop antibodies against certain specific proteins (β-lipoproteins and immunoglobulins) more readily than other transfused patients. The development of these antibodies in the Italian thalassaemic children may be inhibited by their higher frequency of splenectomy.