Kaposi''s sarcoma and HTLV-III: a study in Nigerian adult males.

Sera from 37 adult Nigerian men with Kaposi's sarcoma (KS), 30 contemporaneous controls bearing primary cell carcinoma of the liver (PCL), and 150 healthy non-tumour-bearing negative controls were tested for antibody to human T-cell lymphotropic virus type III/lymphadenopathy associated virus (HTLV-III/LAV) by enzyme-linked immunosorbent assays (ELISA). Certain immunocellular functions were also measured: the chemotactic locomotion of peripheral blood monocytes towards casein, delayed-type cutaneous hypersensitivity reaction to tuberculoprotein and opportunistic infection with the fungus Candida albicans. Sera from all these groups were also tested for markers of previous infections with the viruses cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B (HBV) and hepatitis A (HAV). All serum samples tested were reproducibly and consistently negative for anti-HTLV-III/LAV. Peripheral blood monocytes from both KS and PCL patients showed profound depression of chemotaxis; similarly all tumour patients gave markedly depressed cutaneous reactivity to tuberculoprotein and uniformly exhibited seropositivity to CMV, EBV, HBV and HAV. A great majority showed evidence of infection with Candida albicans. It is concluded that tropical African KS is not associated with HTLV-III/LAV infection.     

IgM responses to hepatitis-A virus and hepatitis-B core antigen in acute and chronic liver disease in Malawi; possible role of non-A, non-B, hepatitis

Of 33 patients with acute hepatitis in Malawi, 21 had infection by hepatitis-B virus (HBV), five by hepatitis-A virus (HAV) and seven, who had no markers of current HBV or HAV infections, were probably infected by the agent(s) of non-A, non-B, hepatitis. 87 of 88 sera from persons without liver disease contained antibody to HAV and 49 antibody to hepatitis-B surface antigen (anti-HBs) (six were positive for hepatitis-B surface antigen). The diagnosis of recent infection by HAV was made by detecting HAV-specific IGM in single serum samples and, although such tests showed that HAV caused acute hepatitis, its absence in patients with chronic liver disease suggests that, unlike HBV, infection by HAV does not play a role in chronic liver disease in Malawi. Anti-hepatis-B core antigen (anti-HBc)-specific IgM was detected in 19 of 21 patients with acute HBV infection, in three of five HbsAg-positive patients with cirrhosis, but in none of five HbsAg-positive patients with hepatoma.     

Viral hepatitis in Bucharest.

A seroprevalence survey of viral hepatitis was conducted in Bucharest, Romania, between April and July 1990 on a systematic sample of 1355 persons drawn from the general population and groups at higher risk of infection. Sera were tested for hepatitis A, B, and C (HAV, HBV and HCV, resp.) markers using an enzyme-linked immunosorbent assay (ELISA) method. The prevalences of HAV and HBV markers were high in all groups. A total of 47% of the adults from the general population and 39.8% of the children aged 0-16 years had at least one HBV marker. Of the pregnant women 7.8% were positive for hepatitis B surface antigen. Among infants (0-3 years of age) living in orphanages, the prevalence of at least one HBV marker was 54.6%. The findings also confirmed that HCV was circulating in Romania. The results are consistent with national surveillance data and confirm that viral hepatitis is a major public health problem in Romania. Preventive measures will have to include HBV immunization of infants, with an appropriately targeted immunization strategy being determined through further epidemiological studies.     

Hepatitis virus non-A, non-B: the cause of a major public health problem in India

Serological studies of hepatitis viruses A and B were carried out on 362 patients with acute viral hepatitis, 130 with fulminant hepatitis, and 56 with subacute hepatitis, and on samples of serum from 230 subjects during epidemics of viral hepatitis. A diagnosis of non-A, non-B viral hepatitis was made when serological tests showed that anti-HAV IgM and anti-HBc IgM were absent. Hepatitis virus non-A, non-B was the causative agent responsible for 58% of cases with acute viral hepatitis, 58% with fulminant hepatitis, 87% with subacute hepatitis, and 66% with epidemic hepatitis. A considerable proportion of patients (6-32%) were infected with both hepatitis virus non-A, non-B and hepatitis virus B. Viral hepatitis non-A, non-B is probably transmitted by infection of drinking-water and is the principal cause of hepatitis in India.     

Evidence of a 1985-1987 outbreak of acute and chronic hepatitis in Egypt caused by a mutant hepatitis-B virus detected by spot-DNA hybridization test.

Sera from 65 acute and 113 chronic sporadic hepatitis were screened for serological markers of hepatitis-B virus (HBV) and hepatitis delta virus (HDV) and for HBV-DNA. The enzyme linked immune sorbent assay (ELISA) and dot-DNA hybridization tests were used. Two HBV-DNA probes and their labelling systems (biotin, radiolabelling with 32P and digoxigenin) were compared for sensitivity and specificity. The 65 acute sera had serological parameters of HBV infection in 38 (58%) when all these sera were HBsAg, IgM anti HBcAg positive plus HBeAg presence in 11/38 sera. Some of the acute sera had markers of acute HBV and HDV coinfection in 14 and superinfection in 13. Thus HBV with HDV represented 27 (41.5%) of the acute hepatitis in this study. Correlation of these serological markers with dot-DNA hybridization results showed that serum HBV-DNA was present in 36/38 (94.7%) of the acute HBV infection. In the case of acute HBV+HDV positive antigenemia 4/6 had serum HBV-DNA while 10/21 of acute HBV with anti-deltaV. IgM had serum HBV-DNA. There were four cases that gave HBV-DNA positivity in sera without combination of HBV markers suggesting infection with "mutant" HBV. In the chronic hepatitis sera there were markers of HBV past infection (IgG anti HBc in 63/113 and IgG anti HBs in 36/113). Yet, among these sera there was HBV-DNA positive signals (20/63 and 17/36) respectively. Analysis of some of these HBV markers also suggested infection with "mutant" HBV.     

734例急性病毒性肝炎的病原学分析研究

目的研究急性病毒性肝炎病原学的特征,制定科学的预防措施。方法对2004年1月～2008年12月收治的734例急性病毒性肝炎患者,进行血清病原学分型及流行病学研究。结果 734例中,甲、乙、丙、戊型病毒性肝炎分别占15.7%、17.0%、2.4%和35.2%,未分型者占29.7%;发病年龄主要集中在30～69岁,占67.4%,甲型肝炎15～49岁为发病高峰期占62.7%,乙型肝炎发病年龄集中在15～69岁占96.0%,丙型肝炎发病年龄在15～69岁占94.5%,戊型肝炎30～69岁为疾病高发年龄段占61.3%,未分型年龄集中在50～69岁,占74.3%;男性患者519例,女性患者215例,男女性患者之比为2.4∶1,每年1～2季度为发病的高峰季节,分别占27.6%和36.4%;临床分型中急性黄疸型肝炎453例(61.7%),急性无黄疸型肝炎264例(36.0%),重型肝炎17例(2.3%)。结论急性病毒性肝炎以戊型和未分型肝炎类型为常见,急性黄疸型肝炎是主要的临床类型;注意个人卫生及改善卫生条件有助于预防甲型肝炎和戊型肝炎传播,接种甲型肝炎和乙型肝炎疫苗是有效的预防措施。     

甲乙丙型肝炎病毒重叠感染情况分析

目的 了解甲型肝炎病毒(HAV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)重叠感染情况。方法 应用ELISA法分别对283重叠感染者检测血清抗-HAV、抗-HCV和HBV-M,并比较各型临床类型各型病毒的感染情况。结果 肝炎病毒感染者中HBV的感染率最高86.9％,HAV和HBV的重叠感染最多42.8％,HBV和HCV重叠感染次之32.9％。结论甲型肝炎、乙型肝炎和丙型肝炎可以重叠感染。以HBV的感染为主,重叠感染加重病情。     

5 805例病毒性肝炎的病原学分析

[目的]研究上海市普陀区人群病毒性肝炎病原学的特征,制定科学的预防措施。[方法]对1990年1月~2003年12月在普陀区中心医院门诊就诊的5805例病毒性肝炎患者,进行血清病原学分型及流行病学研究。[结果]5805例中,甲、乙、丙、丁、戊型病毒性肝炎分别占21.45%、49.96%、1.19%、0.07%、3.50%,未分型者占14.26%,混合感染型占9.58%。年龄分布主要集中在20~49岁,占70.94%。甲肝病例中10~39岁者占83.53%,乙肝中20~49岁者占71.69%。男性患者3836例,女性患者1969例,男女性患者之比为1.95∶1。职业分布情况,干部1529例(26.34%),工人1565例(26.96%),学生477例(8.22%),农民414例(7.13%),其他1820例(31.35%)。每年1~3月为高发季节,分别占9.84%、10.47%和10.73%,其他月份病例数占6.58%~8.72%。1992~1994年间发病数高于其他年份。临床分型中急性黄疸型肝炎3332例(57.40%),急性无黄疸型肝炎846例(14.57%),慢性肝炎1435例(24.72%),重型肝炎52例(0.90%),肝炎肝硬化140例(2.41%)。[结论]甲型和乙型病毒性肝炎是普陀区常见的肝炎类型。急性黄疸型肝炎是主要的临床类型。注意个人卫生有助于预防甲肝和戊肝传播,接种甲肝疫苗和乙肝疫苗是有效的预防措施,肝炎疫情监测及不同对策亦应加强。     

Delta virus infection in Egypt.

The present study was carried out on 124 serum samples of acute hepatitis B, 51 with chronic HBV infection, and 41 chronic HBsAg carriers. Sera were tested by ELISA for HBV markers and anti-delta (anti-HDV). Delta infection (anti-HDV) in acute HB was found to be 16.9% (21 out of 124), 23.5% in chronic HB cases (12 out of 51), and 21.9% among chronic HBsAg carriers (9 out of 41). Out of the twelve delta positive in chronic HB patients, ten (83%) were suffering from CAH (chronic active hepatitis) denoting a possible role of delta infection in deteriorating the course of the disease. A competitive inhibition of HBV replication by coexistent delta infection was demonstrated in the present study. This was reflected on anti-HBc IgM in the acute cases and on HBeAg in chronic HB cases. Anti-HBc IgM was 71.42% (15 out of 21) in delta positive acute HB patients versus 92.23% (95 out of 103) in delta negative acute HB patients. On the other hand, HBeAg percentage was 8.33% (1 out of 12) and 46.15% (18 out of 39) in delta and non-delta chronic HB patients respectively. The difference in both anti-HBc IgM and HBeAg as regards delta positive and negative patients was found to be statistically significant. Out of the twelve chronic HB cases with delta infection, four cases were negative for HBsAg (33.33%). This observation might be attributed to the clearance effect of hepatitis D virus (HDV) on HBsAg (Ischimura et al., 1988) or due to suppressing effect resulting in low undetectable HBsAg level in serum, (Sherlock, 1989). From the present study it may be concluded that delta infection is endemic in Egypt (its incidence ranged from 16.94% in acute HB to 23.53% in chronic HB infection), delta infection possibly also worsens the outcome of chronic HB patients. Delta infection may exert a competitive inhibitory effect on HBV replication.     

The aetiology of acute viral hepatitis in the western region of Saudi Arabia

Of the 1050 sera of acute viral hepatitis patients admitted to the Infectious Diseases Hospital in Jeddah, Saudi Arabia, over a one-year period, 40.9% were due to hepatitis A, 21.5% to hepatitis B, and 37.6% to non-A, non-B (NANB) hepatitis. The mean age for hepatitis A patients was 4 +/- 2.4 years, with no sex preponderance. The mean ages for hepatitis B and NANB were 26.1 +/- 11.9 and 28.8 +/- 14.2 years, respectively. A male to female ratio of 2:1 was noticed for both. 10% of HBsAg patients were positive for anti-delta. 32% of NANB cases were excluded on the bases of possessing specific IgM against cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV) or Treponema pallidum. Only 9% of NANB cases had a history of blood transfusion. In conclusion, nearly all cases of acute jaundice in Saudi children are due to hepatitis A, whereas hepatitis B and NANB generally occur in adults. Other viruses such as CMV, HSV, and EBV are highly prevalent and must be excluded in all cases of NANB hepatitis.     

The seroepidemiology of hepatitis A and B in a Japanese town.

Sera collected from 1,118 healthy children and adults aged between four years and 90 years during the period 1989 to 1990, were tested for serological markers of hepatitis A virus (HAV) [antibody to HAV (anti-HAV)] and hepatitis B virus (HBV) [hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBsAb)]. The overall prevalence rates of anti-HAV, HBsAg, and anti-HBV were 20.2%, 0.36%, and 5.1%, respectively. No body was found to be positive for anti-HAV below 30 years of age but more than 70% of the adults aged 50 years or over were positive for anti-HAV. The level of exposure of HAV infection is declining in Japan and paradoxically at the same time a vast majority of people are becoming susceptible to more severe illness. The fall in prevalence of HBsAg possibly represents the positive impact of ongoing vaccination programs and other preventive measures against HBV.     

Vaccination against hepatitis A virus may not be required for schoolchildren in northern India: results of a seroepidemiological survey

OBJECTIVES: To evaluate the current seroprevalence of antibodies against hepatitis A virus (HAV) in a sample of schoolchildren above 10 years of age and to determine the prevalence of HAV-induced hepatitis in adults at a tertiary care hospital in northern India between January 1992 and December 2000. METHODS: Sera from 276 male and 224 female schoolchildren aged 10-17 years were tested for anti-HAV antibodies by enzyme-linked immunosorbent assay. Consecutive patients with a diagnosis of acute viral hepatitis who attended a liver clinic were tested for the serological markers of HAV, hepatitis B Virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus. FINDINGS: Of the male and female children, 96.3% and 98.2%, respectively had anti-HAV antibodies in their sera. The prevalence of these antibodies in the age groups 10-12, 13- 14, and 15-17 years were 98.6%, 94.8%, and 98.3% respectively. The frequency of HAV- induced acute viral hepatitis (69/870, 8%) in adults did not show an increasing trend. CONCLUSION: Mass HAV vaccination may be unnecessary in northern India because the seroprevalence of protective antibodies against HAV in schoolchildren aged over 10 years remains above 95% and there has been no apparent increase in HAV-induced acute viral hepatitis in adults.     

Positive test results for acute hepatitis A virus infection among persons with no recent history of acute hepatitis--United States, 2002-2004

Hepatitis A is a nationally reportable condition, and the surveillance case definition includes both clinical criteria and serologic confirmation. State health departments and CDC have investigated persons with positive serologic tests for acute hepatitis A virus (HAV) infection (i.e., IgM anti-HAV) whose illness was not consistent with the clinical criteria of the hepatitis A case definition. Test results indicating acute HAV infection among persons who do not have clinical or epidemiologic features consistent with hepatitis A are a concern for state and local health departments because of the need to assess whether contacts need postexposure immunoprophylaxis. This report summarizes results of three such investigations, which suggested that most of the positive tests did not represent recent acute HAV infections. To improve the predictive value of a positive IgM anti-HAV test, clinicians should limit laboratory testing for acute HAV infection to persons with clinical findings typical of hepatitis A or to persons who have been exposed to settings where HAV transmission is suspected.     

湖州市病毒性肝炎血清流行病学调查

目的了解湖州市自然人群病毒性肝炎感染情况与流行病学特征。方法在湖州市按农村山区、平原水乡、城镇,随机抽取1 666名健康人为研究对象,用酶联免疫吸附试验检测血清甲型肝炎(甲肝)病毒抗体(抗-HAV)、乙型肝炎(乙肝)病毒表面抗原(HBsAg)、乙肝病毒表面抗体(抗-HBs)、乙肝病毒核心抗体(抗-HBc)、乙肝病毒e抗原(HBeAg)、乙肝病毒e抗体(抗-HBe)、丙型肝炎(丙肝)病毒抗体(抗-HCV)、戊型肝炎(戊肝)病毒抗体(抗-HEV),同时调查相关危险因素。结果湖州市自然人群的HAV、乙肝病毒(HBV)、HEV标化流行率分别为53.93%、36.47%、38.88%,抗-HCV阳性2例,未发现丁型肝炎病毒(HDV)感染者;HAV流行率与年龄呈正相关(r=0.944),城镇、平原水乡HAV流行率的差异有非常显著的统计学意义(P<0.01);HBV流行率<10岁儿童最低,为4.93%;HBsAg携带率为4.14%,<10岁儿童携带率为0;人群HBV标志物存在11种不同组合模式。HEV流行率随年龄增长而逐渐升高(r=0.993),城镇和平原水乡与山区HEV流行率的差异有非常显著的统计学意义(P<0.001),且存在家庭聚集性现象。结论湖州市病毒性肝炎主要流行型别为甲、乙、戊型,流行病学特征各不相同;HEV流行率较高,HBV流行率较低,HCV流行率低,未发现HDV感染者;HBsAg携带率低;乙肝疫苗接种效果明显。     

The aetiology of acute hepatitis in Zimbabwe

The cause of acute viral hepatitis in 141 patients admitted to both Infectious Diseases Hospitals in Harare (Zimbabwe) was hepatitis A in 44, hepatitis B in 86 and hepatitis Non-A Non-B in 11. The wide distribution of hepatitis A and B viruses and early exposure to both in Zimbabwe are shown by the high positivity rate for anti-HAV antibody in patients under 10 years old (87.5%) and for anti-HBs antibody in patients over 20 (60%). Among the 86 hepatitis B cases, e and delta systems were also investigated: 66 patients (76.5%) were HBeAg positive, six (7%) anti-HBe positive and 14 (16.5%) negative for both; only one was anti-delta positive. Two cases of fulminant liver failure (both occurring in HBsAg and anti-HBc IgM positive, but delta-markers negative patients) and five cases of hepatoma (only one of whom was negative for all HBV markers) are described.     

Viral hepatitis in a Canadian street-involved population

BACKGROUND: Data on the prevalence and compliance with management of viral hepatitis in the street-involved population are limited. METHOD: Hepatitis A (HAV), B (HBV) and C (HCV) serology and compliance with HBV vaccination were documented in 533 street-involved individuals. RESULTS: The mean age of the study population was 25.7 years (range: 11-65) and 53% were female. Serologic evidence of HAV infection was present in 53%; HBV, 12% (3% ongoing infection); and HCV, 17%. HAV infections were associated with Aboriginal/Metis ethnicity and age over 25 years; HBV with injection drug use (IDU); and HCV with IDU, sex trade work and age over 25 years. Compliance with three-step HBV vaccination was 98%, 77% and 63%. CONCLUSIONS: HAV, HBV and HCV are common infections in urban street-involved persons. Successful HBV (and presumably HAV) vaccination can be achieved in the majority of this population, but concerns exist regarding compliance with more long-term, parenterally-based antiviral therapies.     

Prevalence of hepatitis virus infections in Albanian refugees

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection.One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood.The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections.Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.     

Dissociation of alanine aminotransferase values in acute hepatitis A patients with and without past experience to the hepatitis B virus

Serological markers and peak serum alanine aminotransferase (ALT) values of 140 in-patients with acute hepatitis, either type A (n = 90), or type B (n = 50) were prospectively assessed. In 23 out of the 90 patients with acute hepatitis A, evidence of previous experience with hepatitis B virus (HBV) was found, whereas 35 out of the 50 patients with acute hepatitis B had past contact with hepatitis A virus (HAV). The mean peak ALT values [S.D.] were significantly higher in hepatitis A patients with previous experience with HBV (1413 [704] i.u./l), when compared to those without such experience (842 [464] i.u./l, P less than 0.001). Such a difference was not evident between acute hepatitis B patients, whether or not they had previous contact with HAV. We conclude that when acute hepatitis A is superimposed on past HBV infection an augmented transaminaemia, indicative of enhanced liver cell necrosis, takes place although a definite explanation is lacking. We suggest that individuals with markers of HBV infection should be early candidates for HAV immunization.     

庚型肝炎病毒感染研究

目的　了解山东省HGV感染状况,探讨HGV感染与HCV或HBV感染的关系。方法　应用酶联免疫吸附试验(ELISA)对1082例病毒性肝炎患者、77例非甲至戊型肝炎患者和361名献血员进行了血清抗-HGV检测。结果　共检出血清抗-HGV阳性者53例,阳性率3.49%。丙型肝炎患者血清抗-HGV阳性率(8.93%)显著高于乙型肝炎患者(3.32%)(χ2=8.80,P<0.01)。慢性肝炎患者血清抗-HGV阳性率(4.82%)显著高于急性肝炎患者(0.79%)(χ2=10.79,P<0.01)。重型肝炎患者血清抗-HGV阳性率(8.00%)显著高于急性肝炎患者(χ2=10.23,P<0.01)。结论　HGV感染可表现为病毒携带状态、亚临床型和不同临床类型,丙型肝炎患者较乙型肝炎患者更易重叠感染HGV,HGV与HCV或HBV重叠感染可能与病情加重和慢性化的形成有关