J. E. Maynard

Posttransfusion Non-A, Non-B Hepatitis: Physicochemical Properties of Two Distinct Agents

Abstract Two separate and distinct episodes of non-At non-B hepatitis were induced in each of two chimpanzees by two inocula: one containing a chloroform-resistant agent and the other containing a chloroform-sensitive agent. Both agents were recovered from liver tissue and plasma obtained from a single chimpanzee during the acute and chronic phases of infection with a factor VIII concentrate, respectively. The chloroform-resistant agent did not cause unique changes in hepatocytes; in contrast, the chloroform-sensitive agent did induce the formation of cytoplasmic tubules, convoluted endoplasmic reticulum, and dense reticular inclusion bodies. The latter changes are similar in character to those induced in infected cells by some enveloped mammalian RNA viruses.

Serological markers of hepatitis B virus and alpha-fetoprotein levels preceding primary hepatocellular carcinoma in Alaskan Eskimos.

The availability of stored sera that had been obtained for other investigations permitted examination of the sequential development of hepatitis B virus (HBV) infection markers and alpha-fetoprotein (AFP) in persons who later developed primary hepatocellular carcinoma (PHC). 9 of the 11 PHC subjects had markers of HBV infection. The results showed that HBV infection could have occurred as little as 10 years before the recognition of PHC. Seroconversion from HBeAg to anti-HBe and significant rises of AFP levels occurred as long as 6 years and 2 years, respectively, before clinical onset of PHC. The finding that anti-HBe seems to precede the rise in AFP by several years suggests that in populations with a high incidence of HBV-associated PHC, or in families with high risk of PHC, the best use of AFP screening may be to monitor HBsAg carriers after seroconversion from HBeAg to anti-HBe.

LACK OF CAUSAL ASSOCIATION BETWEEN COXSACKIE B4 VIRUS INFECTION AND DIABETES

An epidemic of Coxsackie B4 virus infection in an isolated group of islands in the Bering Sea in 1967 provided an opportunity to test the suggestion that infection with this virus might be associated with an increased incidence of diabetes. In 1973 islanders were tested by glucose-tolerance tests and their two-hour plasma glucose levels were analysed in the light of serological evidence of CB4 infection five years earlier. There was no evidence of any increased prevalence of diabetes in those who had been infected in 1967.

EARLY DETECTION OF PRIMARY HEPATOCELLULAR CARCINOMA BY SCREENING FOR ALPHA-FETOPROTEIN IN HIGH-RISK FAMILIES: A Case-report

Serum levels of alpha-fetoprotein (AFP) may be raised for up to 2 years before clinical presentation of primary hepatocellular carcinoma (PHC). A group of people judged to be at high risk of PHC because of long-term serological positivity for hepatitis B surface antigen, ethnicity, location of residence, and a strong family history of PHC were screened for increasing levels of AFP. After 1 1/2 years of twice-yearly screening, one of them, a 19-year-old Eskimo man, had a raised AFP level, which continued to rise rapidly over the next 3 months, although the patient remained symptomless and ultrasonography, 99mTc-scan, and computerised tomography of the liver were negative. Hepatic angiography suggested a small tumour in the periphery of the right lobe of the liver, but at laparotomy the right lobe was normal. Instead a tumour was found in the lateral tip of the left lobe. The tumour, a PHC, was resected surgically, and the patient has been well in the 11 months since his operation. His serum AFP level returned to normal 2 weeks after the operation and has remained normal.

DNA: DNA hybridization method for the diagnosis of hepatitis b infection

Hepatitis B viral (HBV) DNA was detected in a hepatoma cell line which produces hepatitis B surface antigen (HBsAg) and in patients with acute hepatitis B. The serum of one patient with acute hepatitis B was found to be infectious when injected i.v. into a chimpanzee up to a dilution of 10(-8). Hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detectable in the same serum sample by radioimmunoassay up to a dilution of 10(-5) and of 10(-3), respectively. Using DNA: DNA hybridization on nitrocellulose membranes, HBV DNA sequences were detectable up to 10(-8) dilution corresponding to the infectivity level. Based on this finding, it appears that DNA: DNA hybridization is the most sensitive method for detecting hepatitis B virus (HBV) infection. In situations with low virus levels it may be the only indicator of the presence of infectious hepatitis B virus. The use of a tritium-labelled probe makes the method economical and adaptable to hospital laboratories.

TRANSFUSION OF PLASMA-PROTEIN FRACTION AND RENAL-ALLOGRAFT REJECTION

Abstract Evidence for an association between Summary prior blood-transfusion and renal cadaver-allograft rejection may be incomplete due to the absence of data on concurrent transfusion of blood derivatives. It is suggested that utilisation of one of these derivatives (plasma-protein fraction) may play a role in cadaver-allograft rejection.