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. 1973 May;14(5):365–368. doi: 10.1136/gut.14.5.365

Liver disease and cell-mediated immunity in hepatitis-associated antigen (HAA) carriers

T D Bolin, A E Davis, A G Liddelow
PMCID: PMC1412686  PMID: 4716503

Abstract

As the incidence of liver disease in hepatitis-associated antigen (HAA) carriers has not been defined and it has been postulated that continuing liver disease is associated with incompetence of the cell-mediated immune system, a prospective study was undertaken to examine both these points.

An increased incidence of HAA carriers was found in a prison population (1·3%). Eighteen of these subjects gave informed consent to further study with liver function tests, liver biopsy, and testing of cell-mediated immunity with dinitrochlorobenzene (DNCB) skin sensitization.

Liver function tests were normal in 10 subjects, mildly abnormal in six (SGPT < 100 IU/litre), and abnormal in two. Serum proteins were normal in all.

Liver biopsy showed that five subjects had chronic aggressive hepatitis, three of whom had normal liver function tests. Eight subjects had persistent hepatitis, three with normal liver function tests. The remainder had acute hepatitis (1), evidence of residual hepatitis (1), or non-specific changes (2). Only one subject had normal histology. Drug addicts, who comprised 56% of the group, had more severe liver disease then those who were not addicts.

The hypothesis that persisting liver disease is associated with impaired cell-mediated immunity was not confirmed in that nine of the 12 subjects with persistent or chronic aggressive hepatitis had a positive response to dinitrochlorobenzene skin sensitization, thus implying normal cell-mediated immunity. The findings of this study suggest that in the presence of continuing antigenaemia liver biopsy is mandatory in order to disclose treatable liver disease.

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Selected References

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

  1. Banke O., Dybkjaer E., Nordenfelt E., Reinicke V. Australia antigen and antibody in 10,000 Danish blood-donors. Lancet. 1971 Apr 24;1(7704):860–861. doi: 10.1016/s0140-6736(71)91532-7. [DOI] [PubMed] [Google Scholar]
  2. Chalmers T. C., Alter H. J. Management of the asymptomatic carrier of the hepatitis-associated (Australia antigen. Tentative considerations of the clinical and public-health aspects. N Engl J Med. 1971 Sep 9;285(11):613–617. doi: 10.1056/NEJM197109092851106. [DOI] [PubMed] [Google Scholar]
  3. Cherubin C. E., Rosenthal W. S., Stenger R. E., Prince A. M., Baden M., Strauss R., McGinn T. G. Chronic liver disease in asymptomatic narcotic addicts. Ann Intern Med. 1972 Mar;76(3):391–395. doi: 10.7326/0003-4819-76-3-391. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Dudley F. J., Fox R. A., Sherlock S. Cellular immunity and hepatitis-associated, Australia antigen liver disease. Lancet. 1972 Apr 1;1(7753):723–726. doi: 10.1016/s0140-6736(72)90234-6. [DOI] [PubMed] [Google Scholar]
  6. Kliman A. Australia antigen in volunteer and paid blood donors. N Engl J Med. 1971 Jan 14;284(2):109–109. doi: 10.1056/NEJM197101142840220. [DOI] [PubMed] [Google Scholar]
  7. Kliman A., Reid N. R., Lilly C., Morrison J. Hepatitis-associated antigen (Australia antigen) in Massachusetts blood donors. N Engl J Med. 1971 Sep 30;285(14):783–785. doi: 10.1056/NEJM197109302851406. [DOI] [PubMed] [Google Scholar]
  8. Krotoski W. A. Hepatitis in prisoner blood donors. N Engl J Med. 1972 Jan 20;286(3):159–159. doi: 10.1056/NEJM197201202860316. [DOI] [PubMed] [Google Scholar]
  9. Muniz F. J., Malyska H., Levin W. C. An antigen in blood from prisoners. N Engl J Med. 1971 Mar 4;284(9):501–502. [PubMed] [Google Scholar]
  10. Prince A. M., Hargrove R. L., Jeffries G. H. The role of serum hepatitis virus in chronic liver disease. Trans Assoc Am Physicians. 1969;82:265–277. [PubMed] [Google Scholar]
  11. Reinicke V., Dybkjaer E., Poulsen H., Banke O., Lylloff K., Nordenfelt E. A study of Australia-antigen-positive blood donors and their recipients, with special reference to liver histology. N Engl J Med. 1972 Apr 20;286(16):867–870. doi: 10.1056/NEJM197204202861604. [DOI] [PubMed] [Google Scholar]
  12. Singleton J. W., Merrill D. A., Fitch R. A., Kohler P. F., Rettberg W. A. Liver disease in Australia-antigen-positive blood-donors. Lancet. 1971 Oct 9;2(7728):785–787. doi: 10.1016/s0140-6736(71)92740-1. [DOI] [PubMed] [Google Scholar]
  13. Soloway R. D., Baggenstoss A. H., Schoenfield L. J., Summerskill W. H. Observer error and sampling variability tested in evaluation of hepatitis and cirrhosis by liver biopsy. Am J Dig Dis. 1971 Dec;16(12):1082–1086. doi: 10.1007/BF02235164. [DOI] [PubMed] [Google Scholar]

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