Hepatitis-Associated Antigen and Antibody and Viral Hepatitis in Uganda

Abstract

Serial blood samples were tested for hepatitis-associated antigen (HAA), and for antibody to HAA (anti-HAA) using the passive haemagglutination technique in forty-four patients with acute viral hepatitis treated at New Mulago Hospital between January 1970 and April 1971. All eight patients who had parenteral or nonparenteral exposure followed by a long incubation period, were shown to have HAA and/oranti-HAA. The remaining thirty-six were sporadic cases and 75% of these were presumed to have HAA-positive hepatitis by the presence of HAA or changing titre of antibodies. Viral hepatitis is a serious disease here, but there was no difference in morbidity and mortality between those who were shown to have HAA-positive hepatitis, and the rest of the patients. Nor was there any correlation between antibody titres and the clinical course of patients with HAA-positive hepatitis. Antibodies to HAA were detected in 34% of 205 control hospital patients. Only 21% of the control subjects positive for anti-HAA had a past history suggestive of viral hepatitis; the remaining 79% presumably had subclinical infection. Infection with the agent of HAA-positive hepatitis is extremely common and endemic in this population, and recurrent exposure has to be postulated in view of the short half-life of anti-HAA in some patients after an acute infection.