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ARTICLE |

A Prospective Study of Posttransfusion Hepatitis: Title and subTitle BreakThe Role of Australia Antigen FREE

David J. Gocke, MD
[+] Author Affiliations

Read as part of the 24th Gibson Lecture at the Columbia-Presbyterian Medical Center, New York, April 1, 1971.

Reprint requests to 630 W 168th St, New York 10032 (Dr. Gocke).


JAMA. 1972;219(9):1165-1170. doi:10.1001/jama.1972.03190350013004
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Transfusion of blood containing Australia antigen (Au) was followed by development of hepatitis, Au antigenemia, or both in 52% of recipients. Another 23% of Au recipients exhibited an immune response. However, transfusion of Au-negative blood was associated with anticteric hepatitis in 16% and icteric hepatitis in 2% of the recipients. The typical Au recipient with hepatitis was Au positive during the acute phase and had a severe clinical illness. In the recipient of Au-negative blood, hepatitis was characterized by Au-negative tests in the acute phase and a mild illness. On the basis of these data, estimates of the relation of Au to the overall problem of posttransfusion hepatitis suggest that Au accounts for approximately 25% of icteric cases. Twenty percent of patients who developed Au antigenemia following transfusion became carriers of the antigen. Patients who became Au carriers tended to have mild or anicteric hepatitis, while those with severe, icteric attacks reverted to the Aunegative state. The frequency of Au antigen in commercial donor blood was 13-fold greater than in volunteer blood.

REFERENCES

Blumberg BS, Sutnick AI, London WT:  Current concepts: Australia antigen and hepatitis . New Eng J Med 283:249, 1970;.
Shulman NR:  Hepatitis associated antigen . Amer J Med 49:669-692, 1970;.
Gocke DJ, Greenberg HB, Kavey NB:  Hepatitis antigen: Detection of infectious blood donors . Lancet 2:248-249, 1969;.
Gocke DJ, Greenberg HB, Kavey NB:  Correlation of Australia antigen with posttransfusion hepatitis . JAMA 212:877-879, 1970;.
Gocke DJ, Kavey NB:  Hepatitis antigen: Correlation with disease and infectivity of blood-donors . Lancet 2:1055-1059, 1969;.
Gocke DJ, Howe C:  Rapid detection of Australia antigen by counterimmunoelectrophoresis . J Immun 104:1031-1032, 1970;.
Vyas GN, Shulman NR:  Hemagglutination assay for antigen and antibody associated with viral hepatitis . Science 170:332-333, 1970;.
Lennette EH:  1964 general principles underlying laboratory diagnosis of viral and rickettsial infections , in Lennette EH, Schmidt NJ (eds): Diagnostic Procedures for Viral and Rickettsial Diseases . New York, American Public Health Assoc, 1964;, pp 1-66.
Snedecor GW, Cochran WG: Statistical Methods . ed 6. Ames, Iowa, Iowa State University Press, 1967;, p 115.
Purcell RH, Walsh JH, Holland PV, et al:  Seroepidemiologic studies of transfusion-associated hepatitis . J Infect Dis 123:406-413, 1971;.
Prince AM, Szmuness W, Millian SJ, et al:  A serologic study of cytomegalovirus infections associated with blood transfusions . New Eng J Med 248:1125-1131, 1971;.

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Blumberg BS, Sutnick AI, London WT:  Current concepts: Australia antigen and hepatitis . New Eng J Med 283:249, 1970;.
Shulman NR:  Hepatitis associated antigen . Amer J Med 49:669-692, 1970;.
Gocke DJ, Greenberg HB, Kavey NB:  Hepatitis antigen: Detection of infectious blood donors . Lancet 2:248-249, 1969;.
Gocke DJ, Greenberg HB, Kavey NB:  Correlation of Australia antigen with posttransfusion hepatitis . JAMA 212:877-879, 1970;.
Gocke DJ, Kavey NB:  Hepatitis antigen: Correlation with disease and infectivity of blood-donors . Lancet 2:1055-1059, 1969;.
Gocke DJ, Howe C:  Rapid detection of Australia antigen by counterimmunoelectrophoresis . J Immun 104:1031-1032, 1970;.
Vyas GN, Shulman NR:  Hemagglutination assay for antigen and antibody associated with viral hepatitis . Science 170:332-333, 1970;.
Lennette EH:  1964 general principles underlying laboratory diagnosis of viral and rickettsial infections , in Lennette EH, Schmidt NJ (eds): Diagnostic Procedures for Viral and Rickettsial Diseases . New York, American Public Health Assoc, 1964;, pp 1-66.
Snedecor GW, Cochran WG: Statistical Methods . ed 6. Ames, Iowa, Iowa State University Press, 1967;, p 115.
Purcell RH, Walsh JH, Holland PV, et al:  Seroepidemiologic studies of transfusion-associated hepatitis . J Infect Dis 123:406-413, 1971;.
Prince AM, Szmuness W, Millian SJ, et al:  A serologic study of cytomegalovirus infections associated with blood transfusions . New Eng J Med 248:1125-1131, 1971;.
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