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Studies on acute hepatitis type a 1. clinico epidemiological studies on viral hepatitis type a by radio immunoassay of anti hepatitis a antibodies



Studies on acute hepatitis type a 1. clinico epidemiological studies on viral hepatitis type a by radio immunoassay of anti hepatitis a antibodies



Acta Scholae Medicinalis Universitatis in Gifu 29(3): 433-447



Serodiagnosis of acute viral hepatitis type A by detection of anti-hepatitis A virus antibody (anti-HAV) using radioimmunoassay (RIA) procedures and clinico-epidemiological studies on viral hepatitis type A were described. In the early phase, viral hepatitis type A could not be diagnosed by competitive binding RIA (HAVAB kit) because it is sensitive for both IgM and IgG, anti-HAV. To assay only IgM-antibody, 59 sera from patients with acute viral hepatitis type A were examined after treatment with 2-mercaptoethanol (2-ME). The M-index (cpm ratio between sera after treatment with 2-ME and sera not treated) was significantly higher in sera from acute phase patients than in sera from individuals with only IgG anti-HAV. Thus, M-index (> 1.72 + 0.35) proved to be useful for diagnosis of acute phase hepatitis type A. Modified competitive binding RIA (HAVAB-M kit) was sensitive and specific for detection of IgM anti-HAV. IgM anti-HAV was examined in 159 sera from patients with acute viral hepatitis type A. The titer of IgM anti-HAV (sample cpm/cut off cpm) reached a maximum 2-3 wk after the onset of illness and fell rapidly in the following 2-3 mo. This procedure thus is of great value in the diagnosis of acute phase hepatitis type A by a single serum specimen. The prevalence of anti-HAV increased with age: 0% in persons < 20 yr of age, 21.7% in those 20-29 yr of age, 38.5% in those 30-34 yr of age, 75% in those, 35-39 yr of age. Serological investigations for IgM anti-HAV, HBsAg [hepatitis B surface antigen] and anti-HBs were carried out in 94 patients with sporadic acute viral hepatitis. There were 23 patients (24.5%) with hepatitis type A, 45 (47.9%) with type B and 26 (27.6%) with type non-A non-B. Of all cases of acute hepatitis type A, 78% were found in March and April. The mean value of TTT and serum IgM levels at the acute phase of illness were significantly higher in type A than in type B. No patient with hepatitis type A developed chronicity, clinically or histo-pathologically. In 27 patients with fulminant hepatitis, none was of the A type.

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