摘要:

Infection of man and chimpanzees with the hepatitis B virus (HBV) is associated with diffuse hepatocellular infection and variable manifestations of disease which may not only reflect the character of the host immune response, but also depend upon differences in the cellular biology of this minimally cytopathic or noncytopathic agent. The presence of hepatocellular injury and the course of disease do not appear to be related to the presence of viral antigens in hepatocytes or to the specific pattern of genome expression. HBV infection is typically associated with both humoral and cellular immune responses to viral and hepatocellular antigens. Whereas cellular effector systems may be responsible for immunologically mediated hepatocellular injury, the patterns of viral antigen synthesis and expression may be modulated by the humoral immune response. Aberration of lymphocyte function occurs during acute hepatitis type B. Thymus-derived lymphocyte function is abnormal and is associated with persistent humoral suppression of T lymphocyte function during the development of the chronic carrier state. Extrahepatic disease appears attributable to the formation and deposition of HBSAgantibody complexes. Current information of the biology and immunology of HBV and other viruses has been integrated into a hypothesis to explain the pathogenesis of injury and events associated with persistent infection. Hepatocellular injury and persistence of viral synthesis may be determined by the regulation of synthesis and hepatocyte surface expression of viral and cellular antigens as well as by the specificity and character of the host immune response. Termination of HBV infection is viewed as suppression of viral genome rather than eradication of infected cells.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Tissue samples from 180 unselected necropsy cases of various forms of hepatitis were examined by histopathology and immunofluorescence. The hepatitis forms studied included acute fulminant hepatitis (28 patients), subacute hepatitis (48 patients), acute fatal hepatitis (24 patients), chronic aggressive hepatitis (26 patients), liver cirrhosis (49 patients), and “minimal” hepatitis (5 patients). Hepatitis B surface antigen and hepatitis B core antigen were detected in 101 patients (56.1 per cent). In these, lesion-bound immune complexes of, hepatitis B surface antigen were found in the liver and extrahepatic locations in 77 patients (76.2 per cent). The latter included activated germinal centers of lymph nodes and spleen, focal hyaline lesions of splenic and renal arterioles, necrotic and/or proliferative lesions of small and medium-sized arteries, and kidney glomeruli with mild proliferative and degenerative lesions. There was an inverse relation of the approximate amounts of hepatitis B surface antigen in the liver and the liver damage, the latter being directly proportional to the amount of HBS Ag immune complexes in the liver and indirectly proportional to their amount in extrahepatic locations and to the severity of lesions at these sites.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Immune mechanisms in hepatitis B virus (HBV) infection were investigated in 16 persons with and without hepatitis using tests for HBSAg, anti-HBs, anti-HBcand,125l-labeled HBSAg binding lymphocytes (ABL) in peripheral blood. Anti-HBC, which is an evidence of a recent or current HBV infection, was detected in all HBSAg positive sera. High counts of ABL correlated with the presence of anti-HB5in serum but not with anti-HBcor with HBSAg. In patients with chronic hepatitis, and in asymptomatic carriers of HBSAg, there was a trend towards low counts of ABL, which may represent partial tolerance to HBSAg in carriers of this particle. Further work on ABL for HBSAg and HBCAg should enhance our understanding of immunologic responses to the antigens of the hepatitis B virus.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Type A hepatitis maintains itself in human populations without either an extra-human or human reservoir. Intestinal carriers do not appear to be epidemiologically important; viremic carriers have not been demonstrated. Person-to-person transmission by the fecal-oral route is the usual mechanism. Epidemic and endemic occurrence is usually recognizable by well-defined characteristics; a “hyperendemic” pattern has not been documented. In some countries, but not all, the long-term trend of type A disease has been downward in recent years.Type B hepatitis is worldwide in distribution, and capable of maintaining itself by a carrier reservoir. Transmission is by multiple mechanisms, with the percutaneous route still of major importance when adequately defined in terms of subtle exposures. Contact-associated transmission probably occurs by both the oral-oral and venereal routes. The long-term trend of type B hepatitis is unknown, but some evidence suggests an increase in the United States apart from the epidemic associated with drug abuse.The existence of additional viruses of human hepatitis is suggested by data concerning transfusion-associated disease and multiple episodes in the same individual.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Morbidity and surveillance data on viral hepatitis cases in the United States since 1970 has revealed plateauing of case rate, continued failure to observe seasonal variation, more general geographic distribution of cases, and persistence, although at progressively lower levels, of highest rates in males 15–29 years of age. Based on results of HBSAg testing, as much as 24 per cent of hepatitis B may be misdiagnosed by physicians and from 18 to 46 per cent of reported cases can be classified hepatitis B, thus suggesting that hepatitis B may account for up to one-half the recognized viral hepatitis in this country. HBSAg-negative hepatitis still seems commonly acquired through close personal contact; hepatitis B patients 15–29 years of age also commonly have personal contact association. Parenteral drug abuse and transfusion of blood and blood products continue to play a role in dissemination of hepatitis B, but hepatitis B seems to account for only about one half of all reported transfusion-associated hepatitis. Case fatality rates for reported cases appear to increase with age but are not higher for HBSAg positive patients than for negative patients.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Viral hepatitis represents one of the important public health problems throughout the world. However, from the very inadequate and sometimes considerably inaccurate world data on the incidence, severity, and mortality of the disease, only tentative conclusions can be drawn. There is, however, reasonably good evidence derived from HB antigen testing that it is more common in tropical countries than in temperate zones. The need for introducing more complete reporting of hepatitis by age and sex, and differential reporting of hepatitis type A, type B and type unspecified is stressed. In addition, information on the WHO program on hepatitis B is presented.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Vertical transmission implies transmission of the hepatitis B virus from mother to infant. This occurs with great frequency (70 to 100 per cent) when the mother has acute hepatitis B near delivery. Studies indicate that transmission may occur transplacentally or during the birth process. Once infected, the infants apparently remain hepatitis B surface antigen carriers with persistent hepatitis indefinitely. The rate of transmission of the hepatitis B surface antigen from asymptomatic carrier mothers to their infants varies from 0 to 40 per cent in different areas of the world. The highest rate is in Taiwan where it was found that neonatal infection correlated with the height of complement fixation of surface antigen in the maternal serum. In our series of carrier mother-infant pairs, three infants became surface antigen positive as neonates; two became positive between three and six months; and one became positive between six and 12 months of age. Two babies developed extremely high titers of antibody to hepatitis B surface antigen the first year of life. In addition, 33 infants who were followed for from three to 42 months developed neither antigen nor antibody positivity.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A survey of 751 families with a total number of more than 3,200 individuals was carried out. The sex-age standardized prevalence of serologic evidence of hepatitis B (HB) was, in families with an index-donor antigen positive, ten times as high, and in those with an index-donor antibody positive, two to three times as high as in control families of the same ethnic background. The frequency of familial aggregation (two or more cases) was also unusually high (39–48 per cent). Familial prevalence and aggregation were found to be associated with family size. The highest prevalence of antigenemia was observed among sibs and parents (11 to 34 per cent) and the lowest among spouses (0 to 5 per cent). Sibs matched to the index-carriers by age showed a four to sixfold higher antigen prevalence than unmatched sibs. An excellent fit with the recessive inheritance hypothesis was obtained in genetic segregation analyses. In two of three matings with both members antigen positive, all progeny were found to be antigen positive. This study provided evidence indicating that familial aggregation and segregation of HB are influenced by both environmental and genetic factors.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Epidemiological data indicate that endemic hepatitis in Greenland is immunologically different from hepatitis type A occurring in large epidemics. The endemic type is characterized by sporadicity, a high incidence in urban areas, and predominance of adult cases indicative of a hepatitis B virus (HBV) etiology. The distribution of hepatitis B surface antigen (HBS Ag) in the healthy population suggests the existence of a hyperendemicity of HBV in some rural areas showing few overt hepatitis cases but a HBS Ag carrier rate up to 25 per cent.

ISSN:0002-9629    

出版商:OVID    

年代:1975

数据来源: OVID