TYPE B-HEPATITIS - INFECTIVITY OF BLOOD POSITIVE FOR E ANTIGEN AND DNA-POLYMERASE AFTER ACCIDENTAL NEEDLESTICK EXPOSURE

To determine the relation between the presence of donor DNA polymerase and e antigen, and recipient hepatitis, coded sera from a controlled trial of hepatitis B immune globulin used to treat individuals accidentally inoculated with HBsAg[hepatitis B surface antigen]-positive blood were tested. All recipients lacked antibody to HBsAg. In 29 of 31 donors, polymerase and e were in perfect agreement; both demonstrated a highly significant correlation with recipient hepatitis (P < 0.001). DNA polymerase/e-negative blood did not cause hepatitis. Blood containing polymerase or e antigen did not cause hepatitis in 6 of 31 and 4 of 18 recipients, respectively. Hepatitis did not correlate with transaminase or duration of antigenemia in the donor. Polymerase and e appear to be indicators of the relative infectivity of HBsAg-positive serum, particularly after small-volume exposure. They may be important determinants in assessing infectivity of chronic carriers of HBsAg and in evaluating efficacy of hepatitis B immune globulin and hepatitis B vaccines.