Abstract
199 children with acute hepatitis hospitalized between 1968 and 1978 were tested for serological markers of hepatitis A and B infection. In 24 out of 28 HBsAg-positive patients, hepatitis B infection was diagnosed because of the disappearance of the antigen during convalescence. The histories of the 171 HBsAg-negative children suggested acute hepatitis A infection in 69% of the patients. This diagnosis could be confirmed in 110 of the 116 tested cases (95%) by a more than fourfold increase in the anti-HAV titer or by detection of anti-HAV of the IgM class. In the 55 HBsAg-negative patients without epidemiological clues as to the type of hepatitis, 40 children exhibited anti-HAV which could be related to acute A infection in 21 out of 22 tested cases. At least 11 patients had to be classified as having non A—non B infection.
The results indicate that a combination of evaluation of the patient's history and selected serological tests will permit a fast preliminary diagnosis. This is important in the clinical management of patients and protection of contacts with immunoglobulin.
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References
Brodersen, M., Richter, E.: Type A hepatitis in HBsAg carrier—an HBsAg-positive non-B hepatitis (in preparation)
Brodersen, M., Folger, W., Rudhart, A.: In der Klinik erworbene Hepatitis-B-Infektionen. Med. Klin. 71, 621–628 (1976)
Dienstag, J. L., Feinstone, S. M., Kapikian, A. Z., Purcell, R., H., Boggs, J. D., Conrad, M. E.: Faecal shedding of hepatitis A antigen. Lancet 1975 I, 765–767
Dietzmann, D. E., Matthew, E. B., Madden, D. L., Sever, J. L., Rostafinski, M., Bouton, S. M., Nagler, B.: The occurence of epidemic infectious hepatitis in chronic carriers of Australia antigen. J. Pediat. 80, 577–582 (1972)
Feinstone, S. M., Kapikian, A. Z., Purcell, R. H., Alter, H. J., Holland, P. V.: Transfusion-associated hepatitis not due to viral hepatitis type A or B. New Engl. J. Med. 292, 767–770 (1975)
Franzen, C., Brodersen, M.: Die akute Virushepatitis im Kindesalter—Ein Beitrag zur Epidemiologie der HBsAg-positiven und-negativen Hepatitis. Mschr. Kinderheilk. 126, 127–132 (1978)
Franzen, C., Brodersen, M., Frösner, G.: Hepatitis non A—non B im Kindesalter. Paper presented on the 75. Tagung der Deutschen Gesellschaft für Kinderheilkunde, 4.–6. Sept. 1978 in Freiburg
Frösner, G. G., Frösner, H. R., Haas, H., Dietz, K., Sugg, U., Schneider, W.: Häufigkeit von Hepatitis-A-Antikörpern in Bevölkerungsgruppen verschiedener europäischer Länder. Schweiz. med. Wschr. 107, 129–133 (1977)
Frösner, G.: Nachweis von Hepatitis-A-Antigen und Antikörpern zur Diagnose der Hepatitis-A-Infektion. Münch. med. Wschr. 119, 825–828 (1977)
Frösner, G. G., Overby, L. R., Flehmig, B., Gerth, H.-J., Haas, H., Decker, R. H., Ling, C.-M., Zuckerman, A. J., Frösner, H.-R.: Seroepidemiological investigation of patients and family contacts in an epidemic of hepatitis A. J. Med. Virology 1, 163–173 (1977)
Frösner, G., Scheid, R., Wolf, H., Deinhardt, F.: IgM anti-HAV determined by reorienting gradient centrifugation for the diagnosis of hepatitis A infection. J. Clin. Microbiol. 9, 476–478 (1979)
Giles, J. P., Krugman, S.: Viral Hepatitis. Immunglobulin response during the course of the disease. J. Am. Med. Ass. 208, 497–503 (1969)
Hadziyannis, S., Gerber, M. A., Vissoulis, C., Popper, H.: Association of cytoplasmic HBsAg with characteristic hepatocytes (“Induction Cells”) of HBsAg carriers. Gastroenterology 64, 174 (1973)
Ling, C.-M., Overby, L. R.: Prevalence of hepatitis B virus antigen as revealed by direct radioimmunoassay with 125-I antibody. J. Immunology 109, 834–841 (1972)
Mancini, C., Carbonara, A., Heremans, J.: Immunochemical quantitation of antigens by single radial immunodiffusion. Int. J. Immunochemistry 2, 235–254 (1965)
Müller, R., Willers, H., Frösner, G. G., Gerlich, W., Knocke, K. W., Sipos, S., Deicher, H., Höpken, W.: The sero-epidemiological pattern of acute viral hepatitis. Infection 6, 65–70 (1978)
Prince, A. M., Brotman, B., Grady, G. F., Kuhns, W. J., Hazzi, C., Levine, R. W., Millian, S. J.: Long incubation post-transfusion hepatitis without serological evidence of exposure to hepatitis B-virus. Lancet 1974 II, 241–246
Purcell, R. H., Wong, D. C., Moritsugu, Y., Dienstag, J. L., Routenberg, J. A., Boggs, J. D.: A microtiter solid phase radioimmunoassay for hepatitis A antigen and antibody. J. Immunol. 116, 349–356 (1976)
Roggendorf, M., Frösner, G. G., Deinhardt, F., Scheid, R.: Comparison of solid phase test systems for demonstrating antibodies against hepatitis A. J. Med. Virol. (in press)
WHO Scientific Group: Viral Hepatitis. WHO Techn. Rep. Ser. 570 (1975)
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Franzen, C., Brodersen, M., Frösner, G. et al. Hepatitis types A, B, and non A—Non B in childhood. Eur J Pediatr 132, 261–269 (1979). https://doi.org/10.1007/BF00496849
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DOI: https://doi.org/10.1007/BF00496849