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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1980 Oct;33(10):949–953. doi: 10.1136/jcp.33.10.949

Chronic liver disease in transfusion-dependent thalassaemia: hepatitis B virus marker studies.

S De Virgiliis, G Fiorelli, S Fargion, G Cornacchia, G Sanna, P Cossu, V Murgia, A Cao
PMCID: PMC1146291  PMID: 7430360

Abstract

The systematic screening of 253 children with transfusion-dependent homozygous beta-thalassaemia revealed a high incidence of hepatitis B virus markers. The highest frequencies of hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc) were found in the group of patients with the smallest number of transfusions, while the highest frequency of antibody to hepatitis B surface antigen (anti-HBs) was detected in the patients who had had the largest number of transfusions. Follow-up of these patients showed (a) a high incidence of acute hepatitis B, which was mainly subclinical; (b) normal hepatitis B surface antigen clearance and normal antibody to hepatitis B surface development; and (c) a high frequency of increased transaminase values for over six months. In all the subjects with persistently high transaminase, histological examination revealed chronic persistent hepatitis or chronic active hepatitis. Apart from two cases of chronic active hepatitis with no B virus markers, and two cases of chronic persistent hepatitis with HBsAg and anti-HBc in the serum, all these subjects were anti-HBs positive but HGsAg and anti-HBc negative.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acute and chronic hepatitis revisited. Review by an international group. Lancet. 1977 Oct 29;2(8044):914–919. [PubMed] [Google Scholar]
  2. Alter H. J., Purcell R. H., Holland P. V., Popper H. Transmissible agent in non-A, non-B hepatitis. Lancet. 1978 Mar 4;1(8062):459–463. doi: 10.1016/s0140-6736(78)90131-9. [DOI] [PubMed] [Google Scholar]
  3. Blumberg B. S., Vierucci A., London W. T., Sutnick A. I. Association of antibodies to Australia antigen with anti-Gm antibodies in Italian patients with thalassaemia. Nature. 1972 Mar 3;236(5340):28–30. doi: 10.1038/236028a0. [DOI] [PubMed] [Google Scholar]
  4. Burrell C. J., Black S. H., Ramsay D. M. Antibody to hepatitis B surface antigen in haemophiliacs on long-term therapy with Scottish factor VIII. J Clin Pathol. 1978 Apr;31(4):309–312. doi: 10.1136/jcp.31.4.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Buynak E. B., Roehm R. R., Tytell A. A., Bertland A. U., 2nd, Lampson G. P., Hilleman M. R. Vaccine against human hepatitis B. JAMA. 1976 Jun 28;235(26):2832–2834. [PubMed] [Google Scholar]
  6. De Groote J., Desmet V. J., Gedigk P., Korb G., Popper H., Poulsen H., Scheuer P. J., Schmid M., Thaler H., Uehlinger E. A classification of chronic hepatitis. Lancet. 1968 Sep 14;2(7568):626–628. doi: 10.1016/s0140-6736(68)90710-1. [DOI] [PubMed] [Google Scholar]
  7. Hoofnagle J. H., Gerety R. J., Ni L. Y., Barker L. F. Antibody to hepatitis B core antigen. A sensitive indicator of hepatitis B virus replication. N Engl J Med. 1974 Jun 13;290(24):1336–1340. doi: 10.1056/NEJM197406132902402. [DOI] [PubMed] [Google Scholar]
  8. Kan Y. W., Schwartz E., Nathan D. G. Globin chain synthesis in the alpha thalassemia syndromes. J Clin Invest. 1969 Nov;47(11):2512–2522. doi: 10.1172/JCI105933. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kattamis C., Syriopoulou V., Davri-Karamouzi Y., Demetriou D., Matsaniotis N. Prevalence of Au-Ag and Au-Ab in transfused children with thalassaemia in Greece. Arch Dis Child. 1974 Jun;49(6):450–453. doi: 10.1136/adc.49.6.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Krugman S., Hoofnagle J. H., Gerety R. J., Kaplan P. M., Gerin J. L. Viral hepatitis, type B, DNA polymerase activity and antibody to hepatitis B core antigen. N Engl J Med. 1974 Jun 13;290(24):1331–1335. doi: 10.1056/NEJM197406132902401. [DOI] [PubMed] [Google Scholar]
  11. Le Bouvier G. L. Editorial: Subtypes of hepatitis B antigen: clinical relevance? Ann Intern Med. 1973 Dec;79(6):894–896. doi: 10.7326/0003-4819-79-6-894. [DOI] [PubMed] [Google Scholar]
  12. Mannucci P. M., Ronchi G., Rota L., Colombo M. A clinicopathological study of liver disease in haemophiliacs. J Clin Pathol. 1978 Aug;31(8):779–783. doi: 10.1136/jcp.31.8.779. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Masera G., Jean G., Gazzola G., Novakova M. Role of chronic hepatitis in development of thalassaemic liver disease. Arch Dis Child. 1976 Sep;51(9):680–685. doi: 10.1136/adc.51.9.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Papaevangelou G., Frösner G., Economidou J., Parcha S., Roumeliotou A. Prevalence of hepatitis A and B infections in multiply transfused thalassaemic patients. Br Med J. 1978 Mar 18;1(6114):689–691. doi: 10.1136/bmj.1.6114.689. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Preston F. E., Triger D. R., Underwood J. C., Bardhan G., Mitchell V. E., Stewart R. M., Blackburn E. K. Percutaneous liver biopsy and chronic liver disease in haemophiliacs. Lancet. 1978 Sep 16;2(8090):592–594. doi: 10.1016/s0140-6736(78)92821-0. [DOI] [PubMed] [Google Scholar]
  16. Purcell R. H., Gerin J. L. Hepatitis B subunit vaccine: a preliminary report of safety and efficacy tests in chimpanzees. Am J Med Sci. 1975 Sep-Oct;270(2):395–399. [PubMed] [Google Scholar]
  17. Risdon R. A., Barry M., Flynn D. M. Transfusional iron overload: the relationship between tissue iron concentration and hepatic fibrosis in thalassaemia. J Pathol. 1975 Jun;116(2):83–95. doi: 10.1002/path.1711160204. [DOI] [PubMed] [Google Scholar]
  18. Schanfield M. S., Scalise G., Economidou I., Modell C. B., Bate C., Zuckerman A. J. Immunogenetic factors in thalassemia and hepatitis B infection. A multicentre study. Dev Biol Stand. 1975;30:257–269. [PubMed] [Google Scholar]
  19. Spero J. A., Lewis J. H., Van Theil D. H., Hasiba U., Rabin B. S. Asymptomatic structural liver disease in hemophilia. N Engl J Med. 1978 Jun 22;298(25):1373–1378. doi: 10.1056/NEJM197806222982501. [DOI] [PubMed] [Google Scholar]
  20. Vierucci A., London W. T., Blumberg B. S., Sutnick A. I., Ragazzini F. Australia antigen and antibody in transfused children with thalassaemia. Arch Dis Child. 1972 Oct;47(255):760–765. doi: 10.1136/adc.47.255.760. [DOI] [PMC free article] [PubMed] [Google Scholar]

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