DISTINCTIONS IN CHRONIC ACTIVE HEPATITIS BASED ON CIRCULATING HEPATITIS-ASSOCIATED ANTIGEN

Abstract

Thirty cases of chronic active hepatitis in a general hospital population were screened for circulating hepatitis-associated antigen (H.A.A.), antinuclear antibodies (A.N.A.), and the L.E.-cell phenomenon. On the basis of these tests, the patients could be divided into three groups: group I (seven) were positive for H.A.A.; group II (nine) had either A.N.A. or L.E. cells; and group III (fourteen) were negative for all three tests. There was no overlap between groups I and II in that no patient positive for H.A.A. demonstrated antinuclear antibodies or L.E. cells. It was noteworthy that six group-I patients had a history compatible with parenteral transmission of hepatitis virus (shared needles or exposure to blood products) and five had an abrupt rather than insidious onset to their illness. In contrast, group-II patients had no such exposure history, and their illness tended to have an insidious onset. Whether the separation of chronic active hepatitis patients in this manner has significance in regard to course, prognosis, or therapy remains to be determined.