Hepatitis-Associated Antigen (HAA) in Acute Viral Hepatitis: Serological and Clinical Studies

Abstract

In a prospective study serial serum specimens from 291 patients (including 99 intravenous amphetamine abusers) with acute viral hepatitis were tested for presence of hepatitis-associated antigen (HAA) with a diffusioningel method. The antigen was found in high frequency in patients with presumed long-incubation serum hepatitis, but not in patients of a small common-source outbreak of short-incubation infectious hepatitis. The incubation period could be determined in 45 cases and was compatible with the period reported for serum hepatitis in the patients with HAA and with the period reported for infectious hepatitis in the patients without HAA. The antigen was found in 48% of the patients without any known hepatitis exposure, indicating that serum hepatitis is a common cause of sporadic hepatitis in urban adults. HAA tended to disappear within the first few weeks after onset of jaundice and chronic persistence of HAA was not found, indicating that this is unusual in previously healthy patients with acute viral hepatitis. The HAA-positive patients had significantly higher maximum levels of total serum bilirubin and liver transaminases, longer periods of hyperbilirubinemia and abnormal transaminase activity, but significantly lower values of the thymol turbidity test The cases with HAA also had lower minimum levels of prothrombin index as compared with the cases without demonstrable HAA. Intravenous amphetamine abuse could not be related to a more severe or prolonged illness.