Hepatitis-associated antigen in pregnant women

Prevalence of hepatitis B virus infection in out-patient alcoholics

Sera from 192 out-patient alcoholics attending a clinic for the treatment of alcoholism were tested for hepatitis B surface antigen (HBsAg) and for antibodies to HBsAg and to hepatitis B core antigen (HBcAg). Three sera (1.5%) were positive for HBsAg. Of the remaining 189 alcoholics, 29 (15%) were positive for one or both antibodies. This prevalence is not significantly different from that found in 137 hospitalized HBsAg-negative patients with alcoholic liver disease (35/137 [26%] were positive for one or both antibodies). However, the prevalence of hepatitis B antibodies in out-patient alcoholics is significantly (p less than 0.01) higher when compared with the prevalence in healthy volunteer blood donors (5/114 [4%] were positive for one or both antibodies). A comparison of out-patient alcoholics positive for one or both antibodies (n = 29) with patients negative for both antibodies (n = 160) revealed that the median age in the former group (46 years) was significantly (p less than 0.05) higher than that in the latter group (40 years).

Prevalence of hepatitis B virus infection among alcoholic patients with liver disease

The aim of this investigation was to elucidate a possible role of hepatitis B virus (HBV) in the pathogenesis of liver diseases in alcoholics. Two hundred and fifty-three alcoholics with liver disease were admitted to two medical departments in Copenhagen during a 15 months period. Seventy-nine patients (31%) showed serological signs (HBsAg, anti-HBs) of previous or active HBV infection. This is a significantly higher prevalence than found in an age-matched control population. Among the 79 patients with HBV markers, a total of 11 was found to be HBsAg-positive. From these 11 patients liver specimens were available for re-evaluation in nine cases. In only three of these liver biopsies, morphological changes indicating alcohol as the aetiological cause were found. In conclusion, different or concomitant aetiology must be considered in alcoholics with liver disease.

Transmission of hepatitis type B from healthy HBsAg-positive mothers

Seventeen mothers, all apparently healthy carriers of hepatitis-B surface antigen (HBsAg) during pregnancy, and their children were studied for four to five years to determine the transmission rate of hepatitis-B virus infection. All the mothers had antibody against hepatitis-B core antigen in addition to HBsAg. One of them, a renal transplant recipient, was persistently positive for hepatitis-B-associated e antigen (HBeAg), while the remaining 16, who were detected during screening of healthy pregnant women were positive for anti-HBe. Evidence of infection was found in the child and husband of the woman positive for HBeAg, while none of the 29 children and five husbands of the anti-HBe-positive women became infected.

Hepatitis B antigen and anitbody in maternal blood, cord blood, and amniotic fluid

Transplacental transmission of hepatitis B virus from hepatitis B antigen carrier mothers was investigated by studying the presence of the antigen and its antibody in maternal blood, umbilical cord blood, and amniotic fluid. Hepatitis B antigen was shown in the umbilical cord blood of 2 out of 14 newborns whose mothers were permanent hepatitis B antigen carriers. The antigen was eliminated from the blood of these newborns in less than 3 months. It was also detected in the concentrated amniotic fluid of one hepatitis B antigen cord blood-positive case. Antibodies (anti-HBs) crossed the placental barrier easily and were found in the umbilical cord blood and in the amniotic fluid. They were not detected in the umbilical cord blood and amniotic fluid of any of the studied newborns of hepatitis B antigen carrier mothers. These data indicate that the fetuses of carrier mothers are exposed to the hepatitis B virus. However, chronic antigen positivity and anti-HBs production was not shown. Occurrence of in utero infection and subsequent resolution cannot be excluded, but it appears more probable that in utero infection is blocked.

Acquisition of hepatitis B antigen in the newborn period

This paper describes six mother and infant pairs where the mother developed serum hepatitis during pregnancy. These findings are compared with those in three Australian antigen carrier mothers and their babies. The literature is also reviewed and it is concluded that neonatal hepatitis seldom occurs in infants whose mothers have hepatitis early in pregnancy or are chronic carriers of Australia antigen. In contrast the risk of infection of infants born to mothers who develop serum hepatitis later in pregnancy or in the puerperium approaches 50%.