Galanti B

Increased lymphocyte adenosine deaminase in typhoid fever.

Adenosine deaminase in the peripheral lymphocytes (L-ADA) was determined in 27 patients with typhoid fever and in 15 normal controls. Increased values of enzymatic activity were found in the typhoid fever patients compared with the controls. The increase was prolonged and not correlated to treatment. L-ADA levels could be related to the immune response.

Treatment of chronic hepatitis B in children with prednisone followed by alfa-interferon: a controlled randomized study.

The efficacy and safety of sequential treatment with prednisone and interferon was evaluated in a randomized, controlled study on 43 children with biopsy proven HBsAg/HBeAg/hepatitis B virus-DNA positive, anti-delta negative, chronic hepatitis (34 chronic persistent hepatitis, 9 chronic active hepatitis). Patients received either a 1-month course of prednisone (0.6 to 0.3 mg/kg per day) followed by interferon alfa-2a (3 MU/m2, thrice weekly, for 12 months; 22 patients) or no treatment (21 patients). At the end of the study (20 months), clearance of hepatitis B virus-DNA and HBeAg seroconversion were observed in nine (41%) of the patients treated with prednisone and interferon and in two (9.5%) of the untreated controls (p = 0.020). Two of the treated patients who lost HBeAg, also cleared HBsAg. In the treated group, 13 (59%) patients had stable normal levels of alanine aminotransferase on their last examination. The baseline serum level of hepatitis B virus-DNA was an important predictor of response. In fact, HBeAg clearance was observed in 75% of patients with a baseline hepatitis B virus-DNA level lower than 100 pg/ml and in none with a level above 100 pg/ml. We suggest that combined treatment with prednisone followed by alfa-interferon may be safe and effective in inducing a stable clearance of HBeAg and, in some cases, of HBsAg in children with chronic hepatitis B and with a low level of viral replication. For children with high levels of viral replication, this regimen seems to be ineffective.

Sensitive ELISA for IgG and IgM anti-albumin autoantibodies not influenced by HBsAg-associated polyalbumin receptors.

An enzyme immunoassay for the detection of IgG and IgM anti-polymerized albumin autoantibodies (AAA) is described. It was found that polyalbumin receptors on HBsAg particles interfere in the detection of IgG AAA when polymerized human albumin (pHSA), but not polymerized bovine albumin (pBSA), is used as coating antigen. Polyalbumin receptors do not appear to interfere in the detection of IgM AAA, with either pHSA or pBSA as coating antigen. All normal sera showed evidence of AAA, of both IgG and IgM classes. Levels of IgG and IgM AAA in sera from most type A and type B acute hepatitis patients were above the range of normal controls. ELISA detection of AAA distinct from HBsAg reactivity can help in understanding the role of these autoantibodies in HBV infection.

Cytomegalovirus as a co-factor of disease progression in human immunodeficiency virus type 1 infection

SummaryCytomegalovirus has been suggested as a co-factor of disease progression in patients with human immunodeficiency virus type 1 infection. Cytomegalovirus infection is highly prevalent among populations at risk of human immunodeficiency virus 1 infection, and has been associated with both an increased susceptibility to infection and a more rapid course of the disease towards immunodeficiency. Cytomegalovirus can have a direct immunosuppressive effect (through infection of immune cells) and can enhance the replication of human immunodeficiency virus (through the transactivation of the genic immunodeficiency virus expression, the stimulation of cytokine production, and the increase in Fc receptor expression on target cells). The role of cytomegalovirus as a co-factor of the progression towards immunodeficiency in subjects infected with the human immunodeficiency virus type 1 needs to be elucidated with more extensive clinical studies and the application of new molecular biology techniques.

Etiological, clinical and laboratory data of post-transfusion hepatitis: A retrospective study of 379 cases from 53 italian hospitals

SummaryAmong the 8,604 cases of acute viral hepatitis hospitalized during 1982 in 53 Italian hospitals, we studied 379 cases of post-transfusion hepatitis, 262 cases which occurred after surgery and 4,576 cases with no history of parenteral exposure. The etiological agents of post-transfusion hepatitis were NANB viruses in 57.8%, HBV in 39.0% and HAV in 3.2% of the cases. CMV and EBV accounted for less than 1.5% of the post-transfusion hepatitis cases. HBV was the main etiological agent (62.2% of the cases) in the post-surgical hepatitis group, where HAV accounted for only 6.1% of the cases. In contrast, in the group with no history of parenteral exposure, hepatitis A was most frequent. Percentages of patients with history of transfusion or surgery were always higher in type B and NANB hepatitis than in type A, suggesting that surgery without transfusion also represents a risk of acquiring type B and NANB hepatitis. No regional differences were observed in the etiological patterns of post-transfusion hepatitis and post-surgical hepatitis. The acute phase of type B post-transfusion hepatitis was more severe than that of NANB post-transfusion hepatitis, as shown by higher serum bilirubin and ALT levels and by a higher case fatality rate.ZusammenfassungIm Jahr 1982 wurden in 53 italienischen Krankenhäusern 8604 Fälle von akuter Virushepatitis stationär behandelt, 379 Fälle von Post-Transfusions-Hepatitis, 262 Fälle von postoperativer Hepatitis und 4576 Fälle ohne Vorgeschichte einer parenteralen Exposition. Bei 57,8% der Fälle von Post-Transfusions-Hepatitis wurden NANB-Viren, bei 39,0% HBV und bei 3,2% HAV nachgewiesen. CMV und EBV waren für weniger als 1,5% der Fälle verantwortlich. HBV war der häufigste Erreger der postoperativen Hepatitis (62,2% der Fälle), nur 6,1% der Fälle wurden durch HAV ausgelöst. Bei Patienten ohne Vorgeschichte einer parenteralen Exposition war dagegen die Hepatitis A am häufigsten. In der Gruppe der Patienten mit B-Hepatitis und NANB-Hepatitis war der Prozentsatz an Patienten mit Bluttransfusion oder Operation in der Vorgeschichte immer höher als bei Patienten mit A-Hepatitis; daraus läßt sich folgern, daß ein chirurgischer Eingriff ohne Bluttransfusion ebenfalls ein Risiko für die Akquisition einer Hepatitis vom Typ B oder NANB darstellt. Im ätiologischen Muster der Post-Transfusions-Hepatitis und der postoperativen Hepatitis waren keine regionalen Unterschiede fetzustellen. Bei Patienten, die nach Bluttransfusion an einer Hepatitis erkrankten, war der akute Verlauf bei B-Hepatitis gemessen an den höheren Bilirubinspiegeln im Serum und ALT-Spiegeln sowie höherer Letalität schwerer als bei der Hepatitis vom NANB-Typ.

Lack of transplacental transmissibility of MHV-3 virus

The authors have studied the transmissibility of the virus MHV-3 by the transplacental route from experimentally infected pregnant mice to their fetuses at term, delivered by caesarean section and likewise by the transplacental or vaginal route from the infected mother to mice spontaneously delivered and entrusted to healthy wet-nurses. In both cases, in spite of the severe maternal infection, no virus was detected in the liver of the young. Other experiments have demonstrated the full susceptibility of mice, in the first hours after birth, to the infection experimentally induced by the intraperitoneal incoulation of virus. The obtained results allow the conclusion that infectious virus does not pass to the young by the transplacental or vaginal route.

Esterase staining of monocytes in suspensions of Ficoll-Paque isolated mononuclear cells

Abstract Reagents for esterase identification of monocytes on slide preparations are suitable for staining Ficoll-Paque isolated mononuclear cells in suspension. The suspension method is rapid and costless, and permits an accurate evaluation of esterase-positive cell percentages in mixed cell populations.

Effect of prednisone priming followed by alfa-interferon in treatment of children with chronic hepatitis B: an interim analysis of a controlled trial.

A six-month analysis of a controlled trial on the treatment of chronic hepatitis B in children shows that prednisone priming followed by alpha-interferon 2A was effective in 6 of 9 treated patients in reducing HBV replication and disease activity.

Immunosuppressive therapy of HBsAg-positive chronic active hepatitis in childhood: a multicentric retrospective study on 139 patients.

We analyzed retrospectively the effect of immunosuppressive therapy in 139 children with HBsAG-positive chronic active hepatitis (CAH) observed in four liver units in Italy from 1974 to 1982. All children had been observed for at least 12 months. Of these 139 patients, 38 were treated with steroids (prednisolone or prednisone from 1 to 2 mg/kg daily), 78 with combination therapy (prednisolone or prednisone 1 mg/kg daily in combination with azathioprine, 2 mg/kg daily) and 23 were not treated. The outcome of the disease was assessed by evaluating clinical, biochemical, and histological parameters on the basis of preselected criteria. Untreated patients deteriorated more frequently than those treated with steroids (34.8% versus 13.2%, p less than 0.05) or those receiving combination therapy (34.8% versus 10.3%, p less than 0.01). Remission or improvement was observed more frequently in steroid-treated and combination-treated patients than in the untreated ones (p less than 0.001 and p less than 0.01, respectively). At the end of the study, only one untreated patient had died of liver failure. Remission was observed in about 10% of patients in the two groups of treatment, but in the untreated one, this event never occurred. Although this study is retrospective and presents some shortcomings, the data clearly indicate that steroid and combination therapy are not deleterious, and are possibly helpful, to children with HBsAg-positive CAH.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes inlymphocyte adenosine deaminase(ADA) and purine nucleoside phosphorylase(PNP) levels in lung cancer after radical surgery: 176

Patients with solid tumors have low lymphocyte ADA levels, while operated patients without recurrence show normal levels(1). To elucidate whether ADA levels are restored by the surgical removal of tumor, we determined ADA and PNP activities in peripheral mononuclear cells(PMC),in T-enriched and T-depleted subpopulations from 13 healthy controls and from 6 patients with lung cancer before and 1 month after complete removal of tumor. Lymphocyte subpopulations were prepared by rosetting withSRBC. Before surgery the mean PMC ADA value (17.2±4.8 SD ,mU/107 cells)was significantly lower than the control value(24.8±4.9, P<0.01). ADA levels were lower than controls inbothT (18.1±5.1 vs.20.4±3.9) and non-T cells(24.4±5.1 vs.26.7±4.0) .After surgery ADA levels,compared to pre-surgery values ,were increased in PMC (24.2±2.2,P<0.025)and in T-enriched (25.7±7.9, P<0.05),but decreased in T-depleted subpopulations (19.9±6.7). PNP pre-surgery levels did not differ from control values in PMC, T-enriched or T-depleted subpopulations; after surgery, they showed a trend similar to ADA. In conclusion 1 month after radical surgery ADA levels are apparently restored in unseparated PMC, however an ADA increase is found in T-cells,while low levels persist in non-T cells. 1) Russo M. et al.: Br. J. Cancer 43 (1981), 196-200.