The discovery of the Australia antigen, presently referred to as hepatitis B surface antigen(HBsAg) and antibody to´ HBsAg (anti-HBs), has allowed for a more definite characterization of virus B hepatitis. This antigen serves as a marker for the type B hepatitis virus and as such has been invaluable in the prevention of post-transfusion hepatitis, in the diagnosis and epidemiological investigation of sporadic hepatitis, and potentially, in the development of a vaccine for type B hepatitis.
There has been a growing need for more sensitive, simple, rapid and economic methods for detecting this antigen and antibody. Both immune adherence hemagglutination assay for HBsAg and passive hemagglutination assay for anti-HBs are comparable in their sensitivity with radioimmunoassay which is currently known as the most sensitive method for detecting this antigen and antibody. By each LA.H.A. and P.H.A., HBsAg and antiHBs were detected in Korean patients with biopsyproven acute viral hepatitis (89 pts: male 58, female 39), chronic persistent hepatitis (22 pts: male 16, female 6), chronic active hepatitis (99 pts: male 78, female 21), liver cirrhosis (141 pts: male 110, female 31), and hepatoma (60 pts: male 52, female 8), and their relation with liver diseases was studied. The results are as follows:
1) HBsAg was detected in 58.43% of acute viral hepatitis, 75.76% of chronic active hepatitis,´-´,58.16 % of liver cirrhosis, 55.00% of hepatoma and127.27 % of chronic persistent hepatitis. It is then tempting to postulate that the most frequent form of sporadic acute viral hepatitis is type B, and hepatitis B virus infection plays a great role for the development of active chronic hepatitis, liver cirrhosis and eventually hepatoma in Korea.
2) The higher titer of HBsAg was found more frequently in acute viral hepatitis, chronic persistent hepatitis and ´chronic active hepatitis than in liver cirrhosis and hepatoma patients. In acute viral hepatitis and chronic active hepatitis, the *IAHA titer of HBsAg was found higher more frequently in those who had´,persistent or recurrent antigenemia than those whose antigenemia was abolished.
3) In HBsAg-positive cases in which follow-up study of each 1 month, 3 months, and 1 year´s duration was possible, HBsAg was cleared out in 55.10%, 61.54% and 55.65% in each period in acute viral hepatitis, while it was cleared out in 11.11%, 10.00%, and 20.83% in chronic active hepatitis, and in 6.67% (after 1 month) and 14.29 (after 3 months) in liver cirrhosis. Most patients with HBsAg-positive chronic active hepatitis and HBsAg-positive liver cirrhosis showed persistent or recurrent antigenemia.
4) While anti-HBs was detected most frequently in patients with liver cirrhosis (79.43%), higher titer (PHA>16) was found more frequently in patients with acute viral hepatitis (37.08%). The occurrence rate of anti-HBs was not different between HBsAg-positive and HBsAg-negative patients and it was not related to the clearance of HBsAg or the titer of HBsAg.
(This work was supported in part by the grant No. 73-300-12 from China Medical Board of New York, Inc.)through the biopsy of the cervical lymph node, and, liver. Sputum culture was positive, but negative for cerebrospinal fluid, blood and urine. For the identification of Cr yptococcus´, neoformans of, the, genus Cryptococcus, inoculation on white SwissWebster mouse was proceeded. With combination chemotherapy.,of: Amphotericin B (0.83 mg/kg/day) and 5-FC(133 mg[kg,/day) the patient improved in 7 hospital. weeks.
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