Low Initial Titers Research Articles

Potential Association between Shift Work and Serologic Response to Hepatitis B Vaccination among Manufacturing Workers in Republic of Korea.

(1) Background: Shift work can affect physical health and the immune system by altering the body's circadian rhythms. This study investigated the factors associated with the hepatitis B virus (HBV) vaccination response in manufacturing workers, classified by whether they engaged in shift work or not. (2) Methods: This retrospective observational study was conducted among adults employed at two manufacturing companies. Those with negative initial hepatitis B surface antibody (HBsAb) levels before vaccination and who subsequently received a three-dose series of HBV vaccine were enrolled. Hepatitis B surface antibodies were examined for 3 years after the first dose. The endpoint of this study was the failure of a seroprotective anti-HB response after vaccination (HBsAb < 10 mIU/mL). Binary logistic regression models were used to analyze factors associated with response failures. (3) Results: Of the 1103 eligible subjects, 337 (30.6%) were shift workers. The failure rate was numerically higher in the shift workers (9.2%) than in the non-shift workers (7.9%), without statistical significance (p = 0.405). However, after adjustment with the binary logistic regression models, the shift workers had a statistically significantly higher rate of response failures than the non-shift workers (odds ratio 2.87; 95% confidence interval 1.64-5.05, p < 0.001), as did males, older workers, those with a low initial anti-HB titer, those with a vitamin D deficiency, and current smokers. (4) Conclusions: Our findings suggest a possible association between shift work and the serologic responses to HBV vaccination. Novel strategies for vaccination should be considered for shift workers.

Alterations in Aquaporin-4-IgG Serostatus in 986 Patients: A Laboratory-Based Longitudinal Analysis.

This study was undertaken to investigate factors associated with aquaporin-4 (AQP4)-IgG serostatus change using a large serological database. This retrospective study utilizes Mayo Clinic Neuroimmunology Laboratory data from 2007 to 2021. We included all patients with ≥2 AQP4-IgG tests (by cell-based assay). The frequency and clinical factors associated with serostatus change were evaluated. Multivariable logistic regression analysis examined whether age, sex, or initial titer was associated with serostatus change. There were 933 patients who had ≥2 AQP4-IgG tests with an initial positive result. Of those, 830 (89%) remained seropositive and 103 (11%) seroreverted to negative. Median interval to seroreversion was 1.2 years (interquartile range [IQR] = 0.4-3.5). Of those with sustained seropositivity, titers were stable in 92%. Seroreversion was associated with age ≤ 20 years (odds ratio [OR] = 2.25; 95% confidence interval [CI] = 1.09-4.63; p = 0.028) and low initial titer of ≤1:100 (OR = 11.44, 95% CI = 3.17-41.26, p < 0.001), and 5 had clinical attacks despite seroreversion. Among 62 retested after seroreversion, 50% returned to seropositive (median = 224 days, IQR = 160-371). An initial negative AQP4-IgG test occurred in 9,308 patients. Of those, 99% remained seronegative and 53 (0.3%) seroconverted at a median interval of 0.76 years (IQR = 0.37-1.68). AQP4-IgG seropositivity usually persists over time with little change in titer. Seroreversion to negative is uncommon (11%) and associated with lower titers and younger age. Seroreversion was often transient, and attacks occasionally occurred despite prior seroreversion, suggesting it may not reliably reflect disease activity. Seroconversion to positive is rare (<1%), limiting the utility of repeat testing in seronegative patients unless clinical suspicion is high. ANN NEUROL 2023;94:727-735.

Predictors of Conversion from Positive to Negative Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Status (P9-3.011)

<h3>Objective:</h3> The goal of this study is to characterize the clinical course of patients with Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) who seroconvert from a positive to negative MOG antibody status, and to determine predictors of seroconversion. <h3>Background:</h3> MOGAD is a neuroinflammatory disorder characterized by demyelination of the optic nerve, brain, or spinal cord, and can be either relapsing or monophasic. Persistent MOG antibody positivity has been identified as a potential predictor of disease-related relapses, however there has been limited research regarding what determines whether patients remain seropositive or convert to a negative MOG antibody status. <h3>Design/Methods:</h3> The Massachusetts General Hospital Neuroimmunology Clinic maintains a list of patients with MOGAD based on queries of the Massachusetts General Brigham Research Patient Data Registry database and updated with clinic visits. Patients evaluated through July 2022 were included in a chart review focused on MOG serostatus, titer levels, and potential predictors of MOG serostatus. Data analysis was conducted in Stata/SE 17.0. <h3>Results:</h3> We identified 66 patients who had at least 2 MOG antibody tests 6 months apart (60.6% females and 39.4% males). Of these, 47 had persistently positive MOG titers, and 18 had positive titers that became negative. 5 individuals had negative titers that later converted to positive. Of the 18 patients that developed negative titers, only 1 had a subsequent documented relapse, which was associated with discontinued immunotherapy and titers which became positive again at the time of relapse. Predictors of conversion to negative IgG on multivariate logistic regression included low initial MOG titers (defined as titers &lt;1:100), male sex, and childhood onset of disease. <h3>Conclusions:</h3> Low initial MOG titers, male sex, and childhood onset of disease can help predict future conversion to negative MOG serostatus. Further analysis of this cohort will focus on the effect of various immunotherapies and their timing on MOG antibody status. <b>Disclosure:</b> Ms. Hayman has nothing to disclose. The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext). Ms. Romanow has received research support from Freeman Pain Award @ Harvard Medical School. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.

Изменение инфекционного титра черноморского альговируса микроводоросли tetraselmis viridis под влиянием постоянного магнитного поля

In three experiments aimed at studying the effect of a constant magnetic field with a magnetic induction of 600 G and a duration of experiments of 24 and 36 h, it was found that with a low initial titer of the algal virus of the microalgae Tetraselmis viridis, its stay in a magnetic field for 24 h led to an increase in the infectious titer by one order of magnitude. However, when the virus with a higher infectious titer was in a magnetic field for 24 h, no changes in the titer were observed, and after 36 h, its decrease by one order of magnitude was recorded. The results obtained indicate the need for further research in this direction, with using a wider range of algal viruses.

The First North American Experience Using Glycosorb Immunoadsorption Columns for Blood Group-Incompatible Kidney Transplantation.

Background:Blood group incompatibility (ABOi) is the most common barrier to living donor kidney transplantation. Options for such recipients include kidney paired donation (KPD) or desensitization methodology to reduce blood antibody response.Objective:The objective of this study is to report on the first North America experience in ABOi living donor kidney transplantation using Glycosorb ABO immunoadsorption columns.Design:Retrospective observational cohort study.Setting:Renal transplant program at St. Michael’s Hospital, Unity Health Toronto, University of Toronto.Patients:Twenty-six ABOi living donor transplants from August 2011 through February 2020 were undertaken at our center.Measurements:Renal allograft and patient survival postdesensitization for ABOi living donor transplants and isohemagglutinin titer reduction.Methods:Preoperative immunosuppressive regimen consisted of a single dose of Rituximab 375 mg/m2 IV on day −28; tacrolimus, mycophenolic acid, and prednisone to start on day −7. Immunoadsorption treatments with Glycosorb A or B columns were performed on day −7 through day −1 based on anti-A or anti-B titers on Spectra Optia Apheresis System. Immunosuppression included basiliximab, solumedrol followed by oral prednisone, once-daily tacrolimus, and mycophenolic acid. The mean follow-up was 53 months (3-96 months).Results:A total of 26 individuals underwent an attempt at desensitization of whom 24 patients underwent immediate transplant. One patient had a rebound in titers and subsequently was transplanted from a blood group compatible living donor. A second patient had an unrelated medical issue and desensitization was discontinued. Five-year patient survival was 96% and death censored allograft survival was 92%. Posttransplant anti-A or anti-B titers were monitored daily for the first 7 days posttransplant and every 2 days from days 7 to 14. There were no acute rejections seen in this cohort of transplant recipients.Limitations:As our protocol was first initiated as proof of concept, a few recipients had low initial isohemagglutinin titers. This may have contributed to improved clinical outcomes.Conclusions:ABO column immunoadsorption with specific columns is a safe and effective method for ABOi living donor kidney transplantation, and an option when KPD is less than ideal.Trial not registered as this was a retrospective cohort review.

TEROIDES THE STUDY OF THE EFFECT OF HIGH AND LOW STARTING TITRE IN THE MODEL ENVIRONMENTS TO CHANGES IN ACTIVE AND TITRATABLE ACIDITY DURING THE CULTIVATION OF WHITE CABBAGE VARIETIES PARUS LACTIC ACID BACTERIA L. LACTIS AND L. MESENTEROIDES

The aim of the research was to study the dynamics of active and titratable acidity with a low and high initial titer, while cultivating white head cabbage of the variety ‘Parus’ with lactic acid bacteria Leuconostoc lactis VKPM V-12150 and Leuconostoc mesenteroides subsp. mesenteroides VKPM V-8818 in the basic model medium (BMS) and the modified model medium (MMC) during fermentation . In this experiment, two important questions were considered: the creation of favorable conditions for the growth of lactic acid microorganisms and the suppression of undesirable pathogenic microflora, which can eventually lead to product spoilage. One of the key questions is to scale the results of studies related to the fermentation of plant objects by microorganisms on initially non-sterile raw materials that is the requirement to create as possible fast the conditions that restrain the reproduction of Cl. botulinum, preventing toxin accumulation in the product. Therefore, an important factor is the observance for the necessary boundary condition where for international standards, it reaches pH ≤ 4.6, and for Russian standards it reaches pH ≤ 4.2. Hence, an analysis of the experimental data showed that these boundary conditions were reached after the expiration of essentially different time intervals during the cultivation of microorganisms with different starting titers. As a result, it was shown with which lactic acid microorganisms the optimal parameters for the dynamics of active and titratable acidity were obtained, when the boundary condition reached pH 4.2. Since this value determines more stringent requirements for product safety. As a result of studies it was found that optimal parameters for the dynamics of active and titratable acidity when a limit pH value of 4.2 is obtained in the cultivation of lactic acid bacteria L. mesenteroides in the MMC, revealing that the value of the starting titer ranging from 3*103 to 3*105 CFU/g.

Efficient inactivation of MS-2 virus in water by hydrodynamic cavitation

The aim of this study was to accurately quantify the impact of hydrodynamic cavitation on the infectivity of bacteriophage MS2, a norovirus surrogate, and to develop a small scale reactor for testing the effect of hydrodynamic cavitation on human enteric viruses, which cannot be easily prepared in large quantities. For this purpose, 3 mL scale and 1 L scale reactors were constructed and tested. Both devices were efficient in generating hydrodynamic cavitation and in reducing the infectivity of MS2 virus. Furthermore, they reached more than 4 logs reductions of viral infectivity, thus confirming the scalability of hydrodynamic cavitation for this particular application. As for the mechanism of page inactivation, we suspect that cavitation generated OH− radicals formed an advanced oxidation process, which could have damaged the host's recognition receptors located on the surface of the bacteriophage. Additional damage could arise from the high shear forces inside the cavity. Moreover, the effectiveness of the cavitation was higher for suspensions containing low initial viral titers that are in similar concentration to the ones found in real water samples. According to this, cavitation generators could prove to be a useful tool for treating virus-contaminated wastewaters in the future.

Chikungunya and Dengue Risk Assessment in Greece

Objective: The aims of the study were: (1) To assess the mutated CHIKV E1-A226V and DENV II infection and dissemination rates of an Ae. albopictus population established in Athens (Greece) (2) To assess the risk of outbreaks in four Greek localities based on Ae. albopictus population density whose estimate was based on the number of eggs laid in ovitraps. Methods: Under laboratory conditions females were offered blood meal infected with the CHIKV titer of 1X106 TCID 50/mL and DENV II titer of 1.76 X106 TCID 50/mL; at day 11 after oral infection, females were sacrificed, legs were removed and processed for PCR analysis to assess the presence of viral replicates. In order to evaluate the risk of outbreak of CHIKV and DENV II, a pilot monitoring program was started in three Greek localities and in Chania (Crete), to estimate the adult female population density on the base of the number of eggs in the ovitraps. Results: We proved the vector competence of the Greek Ae. albopictus strain for E1-A226V mutated CHIKV and DENV II. Combining the data on the vector competence with those on the female population density, based on the egg density data, the estimated risk of outbreak was relatively low but not negligible. Conclusion: As the vector competence estimated under laboratory conditions was obtained by offering females moderately low initial virus titers, it can be expected a higher vector competence in the field. This consideration, together with a possible increase of the mosquito population due to the global warming effects, make the quantitative ovitrap-based monitoring a necessary and useful tool to estimate the risk of outbreaks.

Risk Factors Associated with Disease Recurrence among Patients with Low-Risk Papillary Thyroid Cancer Treated at the University of the Philippines-Philippine General Hospital.

BackgroundThe management of papillary thyroid carcinoma (PTC) in high-risk patients is well-standardized. However, this is not the case for low-risk patients. Filipinos show a high incidence of recurrence of thyroid cancer. Thus, the identification of risk factors for recurrence in this population could potentially identify individuals for whom radioactive iodine (RAI) therapy might be beneficial.MethodsWe reviewed the medical records of adult Filipinos with low-risk PTC who underwent near-total or total thyroidectomy at the University of the Philippines-Philippine General Hospital. Multivariate logistic regression analysis was used to determine risk factors for recurrence.ResultsRecurrence was documented in 51/145 of patients (35.17%) included in this study. Possible risk factors such as age, sex, family history, smoking history, tumor size, multifocality, prophylactic lymph node dissection, initial thyroglobulin (Tg) level, initial anti-thyroglobulin (anti-Tg) antibody concentration, suppression of thyroid stimulating hormone production, and RAI therapy were analyzed. Multivariate analysis revealed that a tumor diameter 2 to 4 cm (odds ratio [OR], 9.17; 95% confidence interval [CI], 1.62 to 51.88; P=0.012), a tumor diameter >4 cm (OR, 16.46; 95% CI, 1.14 to 237.31; P=0.04), and a family history of PTC (OR, 67.27; 95% CI, 2.03 to 2228.96; P=0.018) were significant predictors of recurrence. In addition, RAI therapy (OR, 0.026; 95% CI, 0.01 to 0.023; P≤0.005), an initial Tg level ≤2 ng/mL (OR, 0.049; 95% CI, 0.01 to 0.23; P≤0.005), and an anti-Tg antibody level ≤50 U/mL (OR, 0.087; 95% CI, 0.011 to 0.67; P=0.019) were significant protective factors.ConclusionA tumor diameter ≥2 cm and a family history of PTC are significant predictors of recurrence. RAI therapy and low initial titers of Tg and anti-Tg antibody are significant protective factors against disease recurrence among low-risk PTC patients.

Association of bovine respiratory disease or vaccination with serologic response in dairy heifer calves up to three months of age.

To investigate the association of bovine respiratory disease (BRD) or vaccination with serologic response in calves. 94 Holstein calves. To assess the association between BRD and antibody titers, 38 calves < 3 months old that were treated for BRD were matched with 38 untreated calves. To investigate the effect of vaccination on antibody titers, 24 calves were randomly assigned to be vaccinated against bovine respiratory syncytial virus (BRSV), bovine viral diarrhea virus types 1 and 2, bovine herpesvirus type 1 (BHV1), and parainfluenza virus type 3 at 2 weeks of age (n = 6), 5 weeks of age (6), and both 2 and 5 weeks of age (6) or were assigned to be unvaccinated controls (6). Blood samples were obtained at I, 2, 5, and 12 weeks for determination of serum neutralization antibody titers against the vaccine viruses, bovine coronavirus, and Mannheimia haemolytica. Antibody rates of decay were calculated. Calves with initial antibody titers against BRSV < 1:64 that were treated for BRD had a slower rate of anti-BRSV antibody decay than did similar calves that were not treated for BRD. Calves with high initial antibody titers against BRSV and BHV1 had lower odds of BRD than did calves with low initial antibody titers against those 2 pathogens. Vaccination at 2 or 5 weeks of age had no effect on the rate of antibody decay. Clinical BRD and the serologic response of dairy calves were associated with initial antibody titers against BRSV and BHV1. Serologic or clinical responses to viral exposure may differ in calves with low passive immunity.

ABO-incompatible living donor liver transplantation is suitable in patients without ABO-matched donor

ABO-incompatible liver transplantation is usually contraindicated because of the risk of antibody-mediated humoral rejection of the graft. We describe 22 successful cases of patients who had living donor liver transplantation (LDLT) from ABO-incompatible donors. The immunosuppressive protocol consisted of rituximab and plasmapheresis prior to LDLT. Plasmapheresis was planned for up to 2 weeks after LDLT aiming at maintaining levels of anti-ABO titers below 1:32. The median age of recipients was 54 years and the median MELD score was 13. The initial range of isoagglutinin IgM and IgG titers were 1:8-1:1024 and 1:2-1:1024, respectively. Preoperative isoagglutinin IgM and IgG titers were achieved less than or equal to 1:8 by performing therapeutic plasma exchange (TPE). While the median number of TPE was 4 (range, 2-18) in all patients, it was 4 (range, 2-8) in the initial low titer group (<1:256) and 8 (range, 6-18) in the high titer group (≥ 1:256). There were no statistically significant differences for liver function tests in the first 2 weeks after transplantation between the groups having high MELD score (≥ 20) vs. low MELD score (<20), local graft infusion vs. systemic infusion, or high initial isoagglutinin titer (≥ 1:256) vs. low initial isoagglutinin titer (<1:256). Patient and graft survival was 100% and there was no acute humoral rejection in recipients at a mean follow-up of 10months (range, 3-21). ABO-incompatible LDLT can be safely performed when rituximab and TPE are used, and may be proposed when ABO-compatible donors are not available.

Outcome Predictors in Treatment of Yaws

To estimate failure rates after treatment with benzathine penicillin and to identify determinants of failure that affected outcomes for yaws, we conducted a cohort study of 138 patients; treatment failed in 24 (17.4%). Having low initial titers on Venereal Disease Research Laboratory test and living in a village where yaws baseline incidence was high were associated with increased likelihood of treatment failure.

Outcome Predictors in Treatment of Yaws

To estimate failure rates after treatment with benzathine penicillin and to identify determinants of failure that affected outcomes for yaws, we conducted a cohort study of 138 patients; treatment failed in 24 (17.4%). Having low initial titers on Venereal Disease Research Laboratory test and living in a village where yaws baseline incidence was high were associated with increased likelihood of treatment failure.

In Vitro Effects of Pomegranate Juice and Pomegranate Polyphenols on Foodborne Viral Surrogates

Pomegranate juice (PJ) has gained popularity because of its associated antioxidant, antimicrobial, anticancer, and anti-inflammatory properties. However, its effects against epidemiologically significant foodborne viruses have not been investigated. In the absence of culturable human noroviruses, feline calicivirus (FCV-F9), murine norovirus (MNV-1), and MS2 (ssRNA) bacteriophage were used as foodborne viral surrogates. The aim of this research was to study the effects of PJ and pomegranate polyphenols (PP) on foodborne viral infectivity. Viruses at high (∼ 7 log(10) PFU/mL) or low (∼ 5 log(10) PFU/mL) titers were mixed with equal volumes of PJ, 8, 16, and 32 mg/mL of PP, or water (control) and incubated for 1 h at room temperature. Viral infectivity after treatments was evaluated using standardized plaque assays. PJ decreased the titer of FCV-F9, MNV-1, and MS2 by 2.56, 1.32, and 0.32 log(10) PFU/mL, respectively, for low titers and 1.20, 0.06, and 0.63 log(10) PFU/mL, respectively, for high titers. Interestingly, FCV-F9 was undetectable after exposure to the three tested PP solutions using both low and high titers. MNV-1 at low initial titers was reduced by 1.30, 2.11, and 3.61 log(10) PFU/mL and at high initial titers by 1.56, 1.48, and 1.54 log(10) PFU/mL with 4, 8, and 16 mg/mL of PP treatment, respectively. MS2 at low initial titers was reduced by 0.41, 0.45, and 0.93 log(10) PFU/mL and at high initial titers by 0.32, 0.41, and 0.72 log(10) PFU/mL after 4, 8, and 16 mg/mL of PP treatment, respectively. PJ and PP resulted in titer reductions of foodborne virus surrogates after 1 h exposure, showing promise for use in hurdle technologies and/or for therapeutic or preventive use. To suggest the use of PJ and PP as natural remedies for foodborne viral illness prevention, their mechanism of action against viral infectivity needs to be further investigated.

Perioperative viral kinetics: New insights or the Emperor's new clothes?

Perioperative viral kinetics: New insights or the Emperor's new clothes?

Cells as vehicles for cancer gene therapy: the missing link between targeted vectors and systemic delivery?

Systemic administration of currently manufactured viral stocks has not so far achieved sufficient circulating titers to allow therapeutic targeting of metastatic disease. This is due to low initial viral titers, immune inactivation, nonspecific adhesion, and loss of particles. One way to exploit the elegant molecular manipulations that have been made to increase vector targeting is to protect these vectors until they reach the local sites of tumor growth. Various cell types home preferentially to tumors and can be loaded with the constructs required to produce targeted vectors. Here we discuss the potential of using such cell carriers to chaperone precious vectors directly to the tumors. The vectors can incorporate mechanisms to achieve tumor site-inducible expression, along with tumor cell-specific expression of the therapeutic gene and/or replicating viral genomes that would be released at the tumor. In this way, the great advances that have so far been made with the engineering of vector tropisms might be genuinely exploited and converted into clinical benefit.

A high panel-reactive antibody rescue protocol for cross-match-positive live donor kidney transplants.

Alloimmunization can present a virtually insurmountable barrier to kidney transplantation. Past protocols to desensitize patients using plasmapheresis and cyclophosphamide have not been broadly applied because of the fear of complications, including high rates of immunologic failure. Fifteen patients with a positive donor-recipient cross-match were desensitized with plasmapheresis to permit live donor (LD) transplantation under newer maintenance immunosuppressants. Pretransplant the patients received plasmapheresis three times weekly for a planned maximum of six treatments, plus intravenous hyperimmune globulin, tacrolimus, mycophenolate mofetil, and prednisone. Patients who were successfully desensitized and received transplants were given 10 days of OKT3 postoperatively. Eleven of the 15 patients became anti-human globulin cross-match-negative after one to five plasmapheresis treatments and underwent LD transplantation. Relatively low initial titers of donor-specific antibody were predictive of successful attainment of a negative cross-match. Few side effects and rejection episodes were observed. All transplant patients remain dialysis-free after 3-26 months of follow-up. A positive cross-match is not necessarily a contraindication to LD transplantation, especially for patients with low donor-specific alloantibody titers.

Multiple-Challenge Study of Host Susceptibility to Norwalk Gastroenteritis in US Adults

In a multiple-challenge study of US adult volunteers with low or high levels of serum antibody to Norwalk virus, Norwalk inoculum 8FIIa was administered to 42 subjects, 22 were challenged 6 months later, and 19 received a third challenge after 6 more months. All 12 with high (greater than or equal to 1:200) but only 19 of 30 with low (less than 1:100) prechallenge titers experienced illness or a fourfold increase in titer after the first challenge (P less than .025). Only 4 of those challenged twice became ill; all had low initial titers but 3 had high titers before the second challenge. None became ill after a third challenge. Nine (47%) had high titers immediately before the third challenge; 3 had low titers before and after each challenge and remained asymptomatic. Thus, preexisting serum antibody to Norwalk virus does not seem to be associated with protective immunity, but antibody levels become associated with protection after repetitive exposure. Short-term resistance lasts greater than or equal to 6 months after challenge, and a small percentage of resistant individuals maintain low antibody titers even after multiple challenges.

Virus-Associated Receptors for Polymerized Human Serum Albumin in Acute and in Chronic Hepatitis B Virus Infection

The receptor for polymerized human albumin, recently identified on the hepatitis B virus, was studied by hemagglutination in 89 patients with acute and chronic hepatitis B virus infection. The receptor, which was differentiated from antialbumin antibodies by immunofluorescence and hemagglutination inhibition, was detected mainly in patients with active virus replication, independently of hepatitis B surface antigen titer. Thirteen of 20 uncomplicated acute hepatitis B cases were positive at clinical onset (mean log2 titer +/- SD: 4.20 +/- 2.46) but became negative during the acute phase, while 5 patients who progressed to chronic hepatitis had significantly higher receptor titers at onset (7.0 +/- 0.0, p less than 0.01) and remained positive afterwards. In chronic hepatitis B virus infection, the receptor was detected in 17 of 30 patients with chronic active hepatitis, in 5 of 12 with chronic persistent hepatitis, and in 2 of 16 healthy carriers. Among hepatitis B e antigen positive cases a wide range in receptor levels was observed, and in longitudinal studies most patients with low initial titers seroconverted to hepatitis B e antibody while patients with higher titers remained persistently hepatitis B e antigen positive. These results indicate that the virus receptor for polyalbumin may represent a useful marker in hepatitis B e antigen positive acute and chronic hepatitis B.

Clinical Trials of Bivalent Influenza A/New Jersey/76-A/Victoria/75 Vaccines in the Elderly

This placebo-controlled evaluation in elderly persons of inactivated influenza virus vaccines containing 200 or 400 chicke cell-agglutinating units of both A/New Jersey/76 and A/Victoria/75 antigens revealed mild systemic reactions in 7.8% and moderate reactions in 4.9% of vaccinees. These reactions were more common after administration of whole-virus than subvirion vaccines, more frequent in females than males, and more frequent in persons with low initial titers of antibody to A/New Jersey antigen. Local inflammation occurred in 18.7% of vaccinees (predominantly females) and frequently was seen with systemic reactions, but did not correlate with antibody response. Titers of antibody to A/New Jersey antigen were initially high and 99% of vaccinees had titers of greater than 1:20 after vaccination. Titers of antibody to A/Victoria antigen were initially low, and 56% of vaccinees had titers of greater than 1:20 after vaccination. Fourfold or greater increases in titer occurred in about 50% of vaccinees for each virus, most often concomitantly. Antibody responses to subvirion and whole-virus vaccines were similar, and increased responses with higher doses coincided with increased reactogenicity. Later revaccinations because of low titers of A/Victoria antibody produced negligible antibody responses.