VIRAL-HEPATITIS, TYPE-B - STUDIES ON NATURAL-HISTORY AND PREVENTION REEXAMINED

Frozen serial serum specimens obtained from past studies on the natural history and prevention of Type B hepatitis in children were retested by radioimmunoassay for the following markers of hepatitis B infection: hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), hepatitis B e antigen (HBeAg) and antibody (anti-HBe), and antibody to hepatitis B core antigen (anti-HBc). The interval between exposure and evidence of viremia (HBsAg) was as short as six days. HBsAg and HBeAg persisted for two to five months and occasionally for more than one year after recovery. After the disappearance of their respective antigens, anti-HBc and anti-HBs persisted for more than seven years and anti-HBe for one to two years. Treatment with hepatitis B immune globulin after exposure induced complete or partial protection or prolongation of the incubation period. Administration of heat-inactivated hepatitis B virus, MS-2 strain, to 29 children induced an inapparent infection in three, characterized by a transient appearance of HBsAg and HBeAg, and the persistence of anti-HBc, anti-HBe and anti-HBs for more than two years. (N Engl J Med 300:101–106, 1979) OUR studies on the natural history and prevention of viral hepatitis have been in progress since 1956. During the past 22 years several thousand residents have been observed at an institution where viral hepatitis was highly endemic. The background and results of these observations have been described in detail in various publications.1 2 3 4 5 6 7 8 9 During the course of our studies serum specimens were obtained on admission to the institution and at periodic intervals thereafter. Aliquots of these specimens were stored at -20°C in a “serum bank.” Thus, during the past two decades, it was possible to preserve many thousands of serial serum. © 1979, Massachusetts Medical Society. All rights reserved.