Hepatitis‐B Virus Markers in Patients with Bleeding Disorders and in Healthy Blood Donors

Abstract

Sera from 113 multiply transfused patients with bleeding disorders of whom 92 (81.4 per cent) were hemophiliacs were tested for such hepatitis‐B virus (HBV) markers as HBsAg, anti‐HBs. anti‐HBc, e‐antigen and anti‐e. For comparison these marker tests were conducted on sera from 398 apparently healthy blood donors, 198 were previously known to be both HBsAg and anti‐HBs negative, 126 were anti‐HBs positive and 74 were HBsAg positive. Among patients with bleeding disorders, overt HBV infections were infrequent (2 per cent) and there was a low prevalence of HBsAg (3.5 per cent), e‐antigen (1 per cent) and anti‐e (0 per cent). However, the prevalence of anti‐HBs (63 per cent) and anti‐HBc (55 per cent) was high. Of the 71 anti‐HBs positive patients with bleeding disorders 54 (76 per cent) were also anti‐HBc positive. The sera of only four patients contained anti‐HBc alone. All but one of the patients with bleeding disorders who were anti‐HBc positive exhibited persistent responses. Anti‐HBc was detected in all the HBsAg positive blood donors and in 113 of 126 (90 per cent) of those who were anti‐HBs positive, but in none who were HBsAg and anti‐HBs negative. The highest titers of anti‐HBc, both among blood donors and patients with bleeding disorders occurred in those who were HBsAg positive. Among patients who were both anti‐HBs and anti‐HBc positive, highest anti‐HBc titers occurred in those aged 31 to 40. Anti‐e was detected in 59 per cent of HBsAg positive and 5 per cent of anti‐HBs positive blood donors, but e‐antigen was detected in none.

Abnormalities of the spleen and liver in patients with hemophilia

“…This observation is in agreement with Islam et al, who detected both antibodies in 62 of 113 patients (54.9%) [23]. Based on complement fixation assays, it has been observed previously that anti-HBc often is detected during the acute phase of hepatitis B infection, with a decline to low or undetectable levels within one year [24].…”

“…Based on complement fixation assays, it has been observed previously that anti-HBc often is detected during the acute phase of hepatitis B infection, with a decline to low or undetectable levels within one year [24]. More recent investigations such as our study and the study of Islam et a1 [23] have used an RIA technique and commonly detect persistent anti-HBc for several years. Detection of anti-HBc along with anti-HBs is now thought to indicate immunity to infection rather than persistent infection [25].…”

“…Peterson and co-workers found anti-HBs in 79.8% of serum samples from hemophiliacs using a radioimmune assay [22]. Islam and co-workers [23] found 62.8% of their 113 patients with chronic bleeding disorders positive for anti-HBs and 4.3% positive for HBsAg; both tests were performed by an RIA technique. However, in the study by Levine et al of 98 hemophiliacs in whom the presence of hepatic dysfunction and splenomegaly was notable, only 13 patients (13%) were positive for anti-HBs and 4 patients (4 %) were positive for HBsAg [6].…”

Hepatitis B Virus Markers in Hematologic Patients: Relation to Transfusion Treatment and Hospitalization

“…The rate of HBV markers in the above-mentioned groups pa rallels that of hemophiliac patients, the group of multitransfused patients exposed most frequently and for the longest period of time to hepatitis agents. In our previous experience [15] the rate of HBV markers in hemophiliac patients reached 85%, in accor dance with data presented by different au thors [20][21][22], and similar to the prevalence found by us in ß-thalassemia major and idio pathic refractory anemia. Furthermore, if we take into account anti-HBs antibody alone (table III), we can postulate that trans fusion treatment may also be responsible for passive transmission of antibodies.…”

Hepatitis B Surface Antigen Circulating Immune Complexes (HBsAg-CICs) in Patients with Bleeding Disorders

“…High prevalence of serological markers of hepatitis B virus (HBV) infection in patients with bleeding disorders has been noted by several authors [5,7,8,10,13,14]. How ever, to the best of our knowledge there have been no reports regarding the presence of hepatitis B surface antigen circulating im mune complexes (HBsAg-CICs) in a haemophilic population so far published.…”