Kashiwagi S

Double point mutation in the core promoter region of hepatitis B virus (HBV) genotype C may be related to liver deterioration in patients with chronic HBV infection.

Background and Aim:  Hepatitis B virus (HBV) genotype C has a more severe pathogenesis than genotype B in Japan. We retrospectively investigated the relationship between HBV genotype and the core promoter (CP) (nt 1762 and 1764) and precore (PreC) (nt 1896) mutations of the HBV genome.

Antiviral Effect of Interferon Therapy for Patients with Chronic Hepatitis C

Thirty-two patients with chronic hepatitis who were positive for hepatitis C virus (HCV) RNA by polymerase chain reaction and had antibody to HCV (anti-HCV), were enrolled in this study. Twenty of them were also positive for antibody to the GOR epitope (anti-GOR). Sixteen of the enrolled patients were treated with human lymphoblastoid interferon for six months. Treatment was initiated with 3 million units of interferon daily for 2 weeks, followed by 3 million units three times a week for 6 weeks and 1.5 million units three times a week for 16 weeks. The efficacy of therapy was assessed by comparison with the results in 16 untreated patients. Aminotransferase values, titre of anti-HCV and anti-GOR antibodies showed significant decreases throughout the therapy compared with baseline levels and the untreated patients. After a 3 month follow-up, nine treated patients (56.3%) had normal aminotransferase activities and six of them eliminated HCV RNA from their sera (37.5%). Three of these six patients became negative for both anti-HCV and anti-GOR antibodies (18.8%). None of the untreated control patients had normal aminotransferase activities or became negative for HCV markers. The present study suggests that human lymphoblastoid interferon can control the disease activity and eliminate hepatitis C virus from patients with chronic hepatitis C.

Long term observation of the effect of intradermal hepatitis B vaccination on mentally retarded patients

Sixty-two patients of two institutions for mentally retarded patients were immunized intradermally with 4 ug doses of plasma-derived hepatitis B vaccine made in Japan, initially at month 0,1, and 6. The three vaccinations induced antibodies in 93.5% (90.9% in those with Downs syndrome (DS), 94.1% in other forms of mental retardation (OMR)) of the vaccinees within 9 months after the first injection, and the percentage of geometric mean titers of antibody above 10 mIU/ml was 89.3% (81.8% DS, 84.3% OMR) within 9 months. Within 2 years, the seroconversion rate showed a significantly higher decrease in subjects with DS (54.5%) than in OMR (86.3%), and the percentage of vaccinees with above 10 mIU/ml also showed a significantly higher decrease in subjects with DS (36.4%) than in those with OMR (74.5%) (p < 0.05). In the OMR patients, the antibody response persisted for 2 years, decreased remarkedly in the DS patients.

Evaluation of a rapid enzyme immunoassay for detection of influenza A virus among adult and elderly patients

Directigen Flu A, an enzyme immunoassay membrane test for the detection of influenza A virus, was compared with serum hemagglutinine inhibition assay in adult and elderly patients. Throat specimens were collected by vigorous swabbing from febrile patients who were suspect for influenza by clinical symptoms and tested with Directigen Flu A. Serum samples were collected from the patients at onset of illness and two to eleven weeks later and tested for antibody titer to influenza A/H1N1, A/H3N2, and B. A total of 57 patients were involved in this study; 32 under 59 years of age and 25 over 60 years of age. Influenza was diagnosed in 42 patients by HI titer elevation (73.7%). Directigen Flu A was positive in 25 patients. Results of Directigen Flu A and HI test agreed in 40 patients. Sensitivity and specificity of Directigen Flu A were 59.5% (25/42) and 100% (15/15), respectively. There was no significant difference in sensitivity between the two age groups. These results indicate the potential usefulness of Directigen Flu A in the surveillance of influenza A infection in the geriatric population. Directigen Flu A gives results within 15 minutes without expensive equipment. Use of Directigen Flu permits the timely administration of antiviral therapy and infection control among hospitalized and institutionalized geriatric patients.