Hepatitis B Virus Surface Antigen Carriers Research Articles

Hepatitis B virus among Saudi children in Gizan, Saudi Arabia.

Using the enzyme-linked immunosorbent assay (ELISA), the prevalence rates for hepatitis B virus surface antigen (HBsAg), antibody to core antigen (anti-HBc), and antibody to surface antigen (anti-HBs) were studied among 325 school children and those seeking treatment for minor ailments in Gizan City, Saudi Arabia. Tests for hepatitis B virus e antigen (HBeAg), antibody to HBeAg (anti-HBe), IgM antibody to HBV core antigen (IgM anti-HBc) and antibody to delta-virus were made in HBsAg carriers. There was a serological evidence of HBV infection in 91 (28%) Saudis of which 11.1% were HBsAg carriers, 9.5% positive for anti-HBs and 7.4% positive only for anti-HBc. There was no intersex difference for positivity for HBsAg, anti-HBs and anti-HBc. The evidence of existing or earlier infection was higher in females. Among HBsAg carriers, none of the 24 was positive for IgM anti-HBc, 12% were positive for HBeAg or anti-HBe. Anti-delta antibody was present in one of the nine carriers tested. HBV infection in Gizan City is acquired fairly early during childhood with little clinical evidence suggestive of an acute hepatitis. Immunization against HBV should be considered in the neonatal period to prevent the long term sequelae of HBV, like cirrhosis and primary hepatocellular carcinoma.

Viral hepatitis markers in patients on haemodialysis in a hyperendemic area.

Antibody profiles for cytomegalovirus (CMV), hepatitis A virus (HAV), hepatitis B virus (HBV) and the delta-agent were determined on 55 serum samples drawn from 55 Saudi patients on maintenance haemodialysis for periods ranging from 1.5 months to 2 years. The exposure rates for CMV, HAV, and HBV were 100%, 100%, and 72.7%, respectively. There was no intersex difference in positivity for HBV surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to HBV core antigen (anti-HBc); 15.4%, 65.4%, 3.8% in males and 6.9%, 55.2%, and 0% in females, respectively. Among six HBsAg carriers, one and three were positive for e antigen (HBeAg) and antibody to HBeAg (anti-HBe), respectively, with two negative for HBeAg and anti-HBe. The six carriers were also negative for anti-delta antibody. A comparison of the above antibody profile to the profile of voluntary blood donors and those seeking treatment for minor ailments in the local general hospital, obtained earlier using identical test procedures, revealed no difference for CMV and HAV exposure rate. The HBV exposure rate was higher in the haemodialysed patients (P less than 0.001). The epidemiological measures for preventing nosocomial viral hepatitis including immunisation of susceptibles, can be supplemented, among carriers, by interferon and acyclovir therapy for active viral replication. In HBV hyperendemic areas, haemodialysis patients exposed to HBV should be screened periodically for early signs of hepatocellular carcinoma.

Hepatitis B virus in Gizan, Saudi Arabia.

The enzyme-linked immunosorbent assay (ELISA) was used to study the prevalence rates for hepatitis B virus surface antigen (HBsAg), antibody to surface antigen (anti-HBs), and antibody to core antigen (anti-HBc) in 724 voluntary donors, students, pregnant women and those seeking treatment for minor ailments in the Gizan area of Saudi Arabia. Tests for hepatitis B e antigen (HBeAg) and e antibody (anti-HBe) were made in HBsAg positive sera. There was serological evidence of an existing or earlier infection in 337 Saudis (46.5%), of whom 12.7% were HBsAg carriers, 25.4% were positive for anti-HBs, and 8.4% were positive only for anti-HBc. The percentage of HBsAg carriers was 19.9% and 9.3% in males and females, respectively (p less than 0.001). The evidence of existing or earlier infection in males (58.7%) was significantly higher than in females (38.7%) (p less than 0.001), with no intersex difference in anti-HBs or anti-HBc. No difference was observed in the positivity of either of the markers, alone or together, between the cord blood and the female population in the child-bearing age of 20-39 years. Corresponding to the values in other age groups, there was an overall fall in the number of HBsAg carriers during adolescence as well as in 20-39-year-old females. Among the HBsAg carriers, there was no significant difference between the two sexes for HBeAg and anti-HBe positivity. The HBsAg carrier rate of 19.9% in males is consistent with the high male dominant prevalence of hepatocellular carcinoma in the Gizan area.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatocellular Carcinoma: One of the World's Most Common Malignancies

Estimates for world and regional frequencies of hepatocellular carcinoma (HCC) vary widely However, physicians and other medical personnel practising in developing 'Third World' countries are in no doubt that this constitutes a major scourge. Furthermore, they know full well that there are few more depressing tasks than caring for a patient with this particular malignancy, for it affects young people (mostly in the third and fourth decades of life and more frequently in men) and there is no satisfactory treatment. The disease is especially common in Africa, particularly in Mozambique and Senegal, and South East Asia (1). Most tumours arise in a cirrhotic liver (when the prognosis is especially poor) and the vast majority are associated with hepatitis B virus (HBV) infections. There are several portals of entry of the virus including tattooing, ritual circumcision, scarification (often carried out by local healers or medicine men) and less frequently blood transfusion and sexual intercourse. But the most common route is by infection from the mother who is a carrier of the HBV surface antigen (HBsAg), in the immediate post-natal period. Diagnosis is usually straightforward and a large hard nodular liver, frequently with an audible bruit, is virtually confirmatory. On clinical grounds however, differentiation from an amoebic liver abscess can sometimes be difficult (1). That hepatocellular carcinoma is a common sequel of the HBsAg carrier-state is beyond question (2). Other evidence that HBV infection is usually the cause has rapidly accumulated over the last decade and can be summarised (3, 4)' (I) there is a geographical correlation between hepatocellular carcinoma and the HBsAg carrier state; (li) patients with hepatocellular carcinoma are approximately 100 times more likely to be HBsAg positive than matched controls; (iii) HBV infections precede hepatic damage and not vice versa; (iv) over a five-year period an HBsAg positive individual carries a 1000 times risk of developing hepatocellular carcinoma compared with controls; (v) chronic HBV infection often progresses to macronodular cirrhosis and then hepatocellular carcinoma (2); (vi) HBV-DNA can be detected in the hepatocellular carcinoma cell genome; (vii) experimental evidence from hepadna virus (which resembles HBV) infection in woodchucks and pekin ducks has confirmed a progression to cirrhosis and hepatocellular carcinoma. The role of non-A non-B virus infections (5) in the production of chronic liver disease is clear, but without serological markers their importance in hepatocellular carcinoma is unknown. It seems unlikely that the delta agent plays a significant part in the aetiology of hepatocellular carcinoma (6); The role of aflatoxin (a product of the fungus, Aspergilhts flavus) is still unclear (I); despite suggestive epidemiological work, mainly in Africa (a high concentration of aflatoxin B has recently been reported in millet beer in Nigeria (7)) supported by some experimental evidence, its importance is unknown. However, it has been suggested that impairment of hepatic microsomal activity (based on a background of

Development of a novel Clq immunoadsorbent for removal of circulating immunecomplexes: Quantitative isolation of hepatitis B virus surface antigen and immunecomplexes

A technique for large scale production of human C1q from plasma by affinity chromatography on an anti-C1q column is described. Affinity purified C1q was covalently coupled to a newly developed agarose polyacrolein microsphere beads immunoadsorbent. This immunoadsorbent was utilized for quantitative removal of artificially formed bovine serum albumin (BSA)-anti-BSA immune complexes (IC). The C1q affinity column was then used for the isolation of immunecomplexes containing hepatitis B virus (HBV) surface antigen (HBsAg) from serum of an HBsAg carrier. Identical columns may be utilized for quantitative removal of a variety of IC from blood of patients with infectious and autoimmune diseases, as well as neoplastic diseases. Furthermore, dissociated immunecomplexes will provide an additional source for purification of specific antigens.