Hepatitis Be antigen and antibody in hepatitis B surface antigen positive blood donors

Maternal ABO and rhesus blood group phenotypes and hepatitis B surface antigen carriage

In view of a persistently high prevalence of hepatitis B surface antigen (HBsAg) carriage in our obstetric population, we examined the association between HBsAg carriage with maternal ABO and rhesus (Rh) blood group phenotypes determined at routine antenatal screening. In a retrospective study, the antenatal screening results of women booked for confinement between 1998 and 2011 in our hospital were examined for the relationship between HBsAg carriage with the ABO and rhesus blood groups, taking into account also the effects of advanced maternal age (≥ 35 years) and parity status (nulliparous or multiparous), and year of birth before or following the availability of the hepatitis B vaccine (1984). HBsAg carriage was found in 9.9%, 9.6%, 9.1% and 10.2% (P = 0.037) for group-A (n = 20 581 or 26.1%), -B (n = 20 744 or 26.4%), -AB (n = 5138 or 6.5%) and -O (n = 32 242 or 41.0%) among the 78705 women in the study cohort. Rhesus negativity was found in 0.6%, and HBsAg carriage was 12.3% and 9.8%, respectively, for the Rh-negative and Rh-positive women (P = 0.071). Carriage rate between group-O and non-O was influenced by nulliparity, age ≥ 35 years and Rh-positive status. Regression analysis indicated that group-B (P = 0.044, aOR = 1.062, 95% CI 1.002-1.127) and group-AB (P = 0.016, aOR = 1.134, 95% CI 1.024-1.256) were associated with HBsAg carriage. Blood groups-B and -AB are associated with increased hepatitis B virus (HBV) infection in our population, and further studies are warranted to elucidate the implications of this on the sequelae of HBV infection.

Hepatitis B in seven hospitals for the mentally handicapped

Patients in seven hospitals for the mentally handicapped were screened for markers of hepatitis B infection. Of 2239 patients, 123 (5.5 per cent) were carriers of hepatitis B surface antigen (HBsAg) and a third of these were 'infectious' (negative for antibody to hepatitis B e antigen). Patients with Down's syndrome (DS) were 18 times more likely to be 'infectious' carriers than those without, and male patients were six times more likely to be 'infectious' carriers than female patients. There was a wide difference in carrier rate among the various hospitals. In the hospital with the highest carrier rate (12.5 per cent), 60 per cent of male patients with DS were carriers of HBsAg and of these two-thirds were 'infectious'. The carrier rate decreased with age, but the proportion of carriers who were hepatitis B e antigen positive was unaffected by age.

Hepatitis-associated markers in the American Red Cross volunteer blood donor population. IV. A comparison of HBV-associated serologic markers in HBsAg-positive first-time and repeat blood donors

The present study was undertaken to determine whether there were any differences in the distribution of hepatitis B virus-(HBV) associated serologic markers among hepatitis B surface antigen-(HBsAg) positive first-time and repeat blood donors. The markers examined in samples from 412 newly identified HBsAg-positive donors (254 first-time and 158 repeat) included HBsAg titer and subtype, HBeAg/anti-HBe, and anti-HBc. Repeat donors were more frequently HBeAg-positive (25.9%) than were first-time donors (17.7%). Anti-HBc and anti-HBe were observed more often among first-time (99.6 and 76%) than repeat (91.8 and 60.8%) donors. No differences were found in the mean HBsAg titer nor in the subtype distribution in the two populations. The frequency of HBeAg positivity and the mean HBsAg titer in blood were significantly lower among first-time donors aged 30 or older as compared to those younger than 30. Such age-related tendencies did not occur among the repeat donors. The profiles of HBV makers suggest that the HBsAg-positive first-time donor group consists predominantly of long-term HBsAg carriers who may have acquired HBV at an early age, while the HBsAg-positive repeat donors have newly acquired infections.

Reexamination of hepatitis B virus subtypes and e-antigen expression by radioimmunoassays

Radioimmunoassay methods were used to determine both the hepatitis B virus (HBV) subtype and hepatitis B e antigen (HBeAg) and antibody (anti-HBe) status of a group of hepatitis B surface antigen (HBsAg)-positive blood donors. The study involved sera containing HBV of the three major occidental subtypes, adw2, ayw3, and ayw2. The previously reported association of the y-type virus with HBeAg and the d types with anti-HBe was again observed. However, when the two y subgroups, ayw2 and ayw3, were considered individually, it was evident that the ayw3 specimens alone accounted for the association with HBeAg while the ayw2 sera were strongly associated with anti-HBe. The study also indicated that the prevalence of HBeAg declined and that of anti-HBe increased progressively with advancing age. On the average, ayw2 donors were significantly older than the adw2 donors, and donors from both of these groups were older than the ayw3 donors. It is postulated that the observed age differences account, at least in part, for the differing prevalence of e markers in the three HBV subtype groups, and that these age differences, in turn, may reflect a tendency for infections with the ayw2 viral strain to persist longer than adw2 infections, and both of these longer than ayw3 infections. Alternately, the three subtypes may represent epidemiologic shifts from remote ayw2 and adw2 infections to more recent ayw3 infections.

Significance of tests for HBeAg and anti-HBe in HBsAg positive blood donors

A sensitive radioimmunoassay method for HBeAg and anti-HBe allowed 98.4% of HBsAg positive blood donors to be classified. HBeAg was more prevalent in blood donors under 30 years of age and anti-HBe was more prevalent in those over 30 years. The mean HBsAg concentration was four times greater in donors with HBeAg than in those with anti-HBe. No significant associations were found with sex, blood groups, or HBsAg subtypes. It is likely that this test system will be extremely useful to blood transfusion centres and hepatitis reference laboratories in the future.