| 1. |
- Widell, Anders, et al.
(författare)
-
IgM antibody to the hepatitis B core antigen in acute hepatitis determined by SPRIA--diagnostic value
- 1982
-
Ingår i: Acta pathologica, microbiologica, et immunologica Scandinavica. Section B, Microbiology. - 0108-0180. ; 90:1, s. 79-84
-
Tidskriftsartikel (refereegranskat)abstract
- A solid phase radio-immunoassay (SPRIA) was developed for the detection of anti-HBc IgM. The assay proved sensitive and easy to perform and rheumatoid factor did not affect the test results. Anti-HBc IgM titres were followed in consecutive samples from 15 patients after uncomplicated acute hepatitis B. In the acute phase anti-HBc IgM titres ranged from 10(-5) to 10(-7) (mean 10(-6.4)). One year after onset of disease ten of the 15 had titres below 10(-4) and between two and three years after onset most patients had titres 10(-3). Anti-HBc IgM titres were determined in six episodes of acute hepatitis B, all HBsAg negative but anti-HBc positive in the first samples obtained (within 8 days) and developing anti-HBs during convalescence. Acute phase anti-HBc IgM titres in these patients ranged between 10(-5.5) and 10(-7) (mean 10(-6.5)) and were thus identical with HBsAg positive cases. When acute phase sera from 168 episodes of acute hepatitis primarily classified as non-A, non-B, were tested for anti-HBc IgM titres above 10(-5), sera from 13 episodes were positive and in seven of these hepatitis B diagnosis could be confirmed by rising anti-HBs titres in convalescence. Sera from four of the 13 patients contained HBeAg, which was thus demonstrated in the absence of HBsAg. The results show that testing for anti-HBc IgM is important for a true non-A, non-B diagnosis.
|
|
| 2. |
- Hansson, B G, et al.
(författare)
-
Infection with delta agent in Sweden: introduction of a new hepatitis agent
- 1982
-
Ingår i: Journal of Infectious Diseases. - 1537-6613. ; 146:4, s. 472-478
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the epidemiology of infection with delta (delta) agent in a Swedish city, 181 chronic carriers of hepatitis B surface antigen (HBsAg) and 599 patients with acute, self-limited hepatitis B were analyzed for delta antigen and antibody to delta antigen (anti-delta). The study covered the period from 1970 to 1981. The delta agent was found to have been introduced to this population in 1973. Markers of infection with delta agent were almost exclusively found in intravenous drug addicts and their close contacts. The proportion of drug addicts who were chronic HBsAg carriers with anti-delta increased with time and reached 72% in 1979-1981. An episode of acute hepatitis was frequently seen in connection with seroconversion to anti-delta. Among the domestic cases of acute, self-limited hepatitis, no simultaneous infections with hepatitis B virus and delta agent were found before 1975. From 1975 to 1980, between 18% and 44% of the drug addicts with acute hepatitis B were also infected with delta agent.
|
|
| 3. |
- Moestrup, T, et al.
(författare)
-
Clinical aspects of delta infection
- 1983
-
Ingår i: British Medical Journal (Clinical Research Edition). - 0267-0623. ; 286:6359, s. 87-90
-
Tidskriftsartikel (refereegranskat)abstract
- The clinical features of delta infection were analysed retrospectively in 191 hepatitis B surface antigen (HBsAg) carriers and 592 cases of acute hepatitis B seen over 11 years in the Swedish town of Malmo (population 250 000). With a few exceptions delta infections occurred exclusively in drug addicts. In the chronic HBsAg-carriers the most common clinical manifestation was an episode of acute hepatitis, which in some individuals became severe with a pronounced rise in serum alanine aminotransferase activity for many months. During the period of delta infection the HBsAg titre was lowered and in three out of 26 cases the patient lost HBsAg altogether and developed hepatitis B surface antibodies (anti-HBs). In one patient the acute hepatitis due to delta infection was fulminant and fatal. In patients with acute hepatitis B the clinical picture did not distinguish between those with and without simultaneous delta infection. The frequency with which acute hepatitis B was succeeded by a chronic carrier state was the same whether or not the patient was infected simultaneously with the delta agent. The discovery of the delta agent has improved understanding of the natural history of chronic hepatitis B infection in drug addicts. Thus, instances of acute hepatitis in a chronic carrier, previously termed hepatitis non-A, non-B, may actually be episodes of delta infection.
|
|
| 4. |
- Moestrup, T, et al.
(författare)
-
Hepatitis B virus-DNA in the serum of patients followed-up longitudinally with acute and chronic hepatitis B
- 1985
-
Ingår i: Journal of Medical Virology. - : Wiley. - 1096-9071 .- 0146-6615. ; 17:4, s. 337-344
-
Tidskriftsartikel (refereegranskat)abstract
- Sera from 79 patients with acute self-limiting hepatitis, 17 patients with acute hepatitis B evolving into chronic HBsAg carriership, and 43 chronic HBsAg carriers without a history of acute hepatitis were analyzed for presence of hepatitis B virus (HBV)-DNA by a molecular hybridization technique. In acute self-limiting hepatitis, HBV-DNA was cleared within a few weeks after the onset of clinical symptoms. The longest period of DNA positivity observed in this group was 42 days. In 29 of 52 patients HBV-DNA was cleared before HBeAg disappeared. Among 17 patients who became chronic HBsAg carriers, HBV-DNA was present for more than 6 months in all but one. Most of the HBsAg carriers eventually cleared HBV-DNA. The DNA clearance frequently preceeded the conversion of HBeAg to anti-HBe. Thus, in many patients there was a transitional period with HBeAg but without HBV-DNA. HBV-DNA was found to be a better index of impending chronicity than HBeAg since persistence of HBeAg for more than 42 days was noted in 10% of the patients who nevertheless cleared HBsAg within 6 months. By that time all those patients had turned negative for HBV-DNA. On the other hand, in 16 of the 17 patients who became chronic carriers of HBsAg, HBV-DNA as well as HBeAg persisted for more than 6 months. The present results also suggest that infectivity in acute hepatitis B is a feature mainly of the presymptomatic and early symptomatic period.
|
|
| 5. |
- Moestrup, T, et al.
(författare)
-
Long term follow up of chronic hepatitis B virus infection in intravenous drug abusers and homosexual men
- 1986
-
Ingår i: BMJ: British Medical Journal. - 1756-1833. ; 292:6524, s. 854-857
-
Tidskriftsartikel (refereegranskat)abstract
- Long term follow up of 16 homosexual men and 78 intravenous drug abusers who were chronic carriers of hepatitis B surface antigen (HBsAg) showed fundamental differences between the two groups. Viral replication, expressed by the presence of hepatitis B e antigen, lasted for four years or more in 10 out of 14 (71%) of the homosexual men whereas it was not present in 43 out of 73 (59%) of the drug addicts within one year. This shows a difference in the immunological response between homosexual HBsAg carriers and addicts that is not related to infection with human T cell lymphotropic virus type III. Severe histological damage such as chronic aggressive hepatitis, cirrhosis, or primary liver cancer was found in more than half of the homosexual men who underwent biopsy examinations. In drug addicts chronic persistent hepatitis was a regular finding in the absence of markers of delta infection, but in those addicts infected with the delta agent the degree of liver damage was comparable with that found in homosexual men.
|
|
| 6. |
- Widell, Anders, et al.
(författare)
-
Antibody to hepatitis-C-virus-related proteins in sera from alanine-aminotransferase-screened blood donors and prospectively studied recipients
- 1991
-
Ingår i: Vox Sanguinis. - 1423-0410. ; 60:1, s. 28-33
-
Tidskriftsartikel (refereegranskat)abstract
- A prospective study of posttransfusion non-A, non-B hepatitis was conducted in Malmo, Sweden, in 1984-1985, in which donors were alanine aminotransferase (ALT) screened but not ALT selected. Among 741 patients studied at 0, 6, and 12 weeks after transfusion, 13 developed non-A, non-B hepatitis, and these were further followed up. Stored sera from the 13 hepatitis patients and their 123 donors were tested for anti-hepatitis C virus (HCV) by ELISA and if positive, analyzed by recombinant immunoblot assay (RIBA). All ALT-elevated blood units (n = 301) and a similar number of ALT-normal units were also tested. Only 4/13 patients with non-A, non-B hepatitis seroconverted to anti-HCV, all with ALT peaks greater than 10 times the upper normal. All seroconversions occurred within 5 months after transfusion and could be confirmed by RIBA. Hepatitis C in recipients occurred both after transfusion of blood that was strongly positive, weakly positive, and/or negative for anti-HCV by ELISA. In donors grouped by ALT levels, the anti-HCV prevalence varied between 0.4 (normal ALT) and 14% (ALT elevated greater than or equal to 2 times). Of the total of 9 donor units positive by ELISA, only 5 were confirmed by RIBA. Of the 5 recipients of the RIBA-positive blood units, 3 went into hepatitis, 1 remained normal at 10.5 weeks, and 1 showed a slight, transient ALT elevation at week 12. The recipients of ELISA-positive but RIBA-negative blood remained healthy.
|
|
| 7. |
- Widell, Anders, et al.
(författare)
-
Increased occurrence of hepatitis A with cyclic outbreaks among drug addicts in a Swedish community
- 1983
-
Ingår i: Infection. - 1439-0973. ; 11:4, s. 198-200
-
Tidskriftsartikel (refereegranskat)abstract
- To determine the prevalence of antibodies to Hepatitis A virus (anti-HAV) among drug addicts, sera collected in a Swedish city during a ten-year period from 234 drug addicts with acute hepatitis B were tested for anti-HAV. The results were compared with the normal population, where only 3.8% of those born after 1950 were anti-HAV-positive. In individuals born between 1941 and 1965, 8.2% in the normal population and 30.2% of the drug addicts were anti-HAV-positive (p less than 0.001). The level of immunity to hepatitis A among drug addicts ranged from 7.7% to 60% during the ten-year period. Low levels of immunity were seen in the years preceeding outbreaks of hepatitis A among drug addicts. These outbreaks occurred in a cyclic pattern. Higher levels of immunity were seen after each outbreak.
|
|
| 8. |
- Widell, Anders, et al.
(författare)
-
Relation between donor transaminase and recipient hepatitis non-A, non-B in Sweden
- 1988
-
Ingår i: Vox Sanguinis. - 1423-0410. ; 54:3, s. 154-159
-
Tidskriftsartikel (refereegranskat)abstract
- The relation between donor alanine aminotransferase (ALT) and recipient post-transfusion hepatitis (PTH) non-A, non-B was studied in patients tested before and 6 and 12 weeks after transfusion. The minimum ALT criterion for PTH was 105 IU/l (greater than 2.5 times the upper normal of 42 IU/l). In 8.8% of donors, ALT was greater than 42 IU/l, and in 2.3% ALT was greater than 63 IU/l, i.e., 1.5 times elevated. PTH non-A, non-B occurred in 14 of 742 recipients. The PTH incidence increased when donor ALT was above 63 IU/l (1.5 vs. 5.6%; p less than 0.05). However, if the confounding factor of volume variations was compensated for, elevated donor ALT and PTH were only statistically linked among recipients less than 70 years (p less than 0.02; Mantel-Haenszel test).
|
|
