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Circulating immune complexes in liver cirrhosis: Relationship with liver function
CIRCULATING IMMUNE COMPLEXES IN LIVER CIRRHOSIS: RELATIONSHIP WITH LIVER FUNCTION 283
M. Rondana, L. Milani, R. Perissinotto*, L. Care~aro~ A. Gatta Department of Clinical Medicine, *Department of Biology, University of Padova
Circulating Immune Complexes (CIC) are frequently found in patients with liver disease. This could be due to a reduced hepatic immune complexes uptake either by Kupffer cells either by hepatocytes(Gastroenterol Clin Biol 7:67-70,1983). The aim of our study is to evaluate the relationship between hepatocytic funtion and CIC. 39 patients with liver cirrhosis of different degree were studied. CIC levels were determl~ ed by Con~lutinin-SolidPhase-Assay(CSPA) and by %SolidPhase-Assaywhich detects CIC of each immunoglobulin class(I~G-/IgA-/IgM-C3SPA). Hepatocytic function was evaluated b y m e a n s of Prealbumin (Pre), Albumin (Alb), Pseudocholinesterase (Pche) plasma levels and Prothrombin Time(PT). CIC levels above normal values (CSPA <44~; IEG-/I~A-/IgM-CSPA
RISK OF POST-TRANSFUSION INFECTION WITH THE HEPATITIS DELTA VIRUS 284
F. Rosina, G. Saracco, M. Rizzetto Division of Gastroenterology, Molinette, Torino Italy; S. Govindarajan, H. Alter,D.J. Gocke (USA), G. Papaevangelou (Greece), W.G. Schiller (GDR), C.A. Lee.(England)) J.P. Simonetti (Brazil), E. Penner (Austria), D. Tapalaga (Romania), G.V. Williams (Australia), G. Hess (GFR).
The most efficient mode of transmission of HBsAg associated hepatitis Delta Virus (HDV) is by direct parenteral inoculation with contaminated blood and blood products. To evaluate the prevalence of post-transfusion (PT) transmission of HDV from blood controlled for HBsAg, we measured antibody to HDV (anti-HD) in patients at risk. Anti-HD was found in 3.5% of 262 Italian, Greek and American patients, who suffered acute HBsAg-positive hepatitis after transfusion with blood. The prevalence of anti-HD was significantly higher in fulminant (4/28, 14.5%) than in benign hepatitis (5/234, 2%) (P<0.05). Based on a negative test for IgM anti-HBc, 3 of the 9 patients with hepatitis accompanied by anti-HD were identified as unrecognized carriers of HbsAg experiencing PT HDV superinfection. Anti-HD was found only in 3 of 94 Italian carriers of HBsAg multiply transfused with blood, in none of 34 Brasilian, East German, Rumanian and Australian haemophilic carriers infused with clotting factors prepared from single or mini-pool volunteer plasma, but in 27%-100% of European and US series including 79 haemophilic carriers treated with factors manufactured from pool of thosands of units of plasma. Screening of blood for HBsAg by third generation assays provides a high degree of safety in prevention of PT HDV infection. The minimal residual risk ~ i in 3.000 blood transfusions) is amplified in carriers of HBsAg. Carriers should be given only blood derivates prepared from single or mini-pool donors.
$320
M. Rondana, L. Milani, R. Perissinotto*, L. Care~aro~ A. Gatta Department of Clinical Medicine, *Department of Biology, University of Padova
Circulating Immune Complexes (CIC) are frequently found in patients with liver disease. This could be due to a reduced hepatic immune complexes uptake either by Kupffer cells either by hepatocytes(Gastroenterol Clin Biol 7:67-70,1983). The aim of our study is to evaluate the relationship between hepatocytic funtion and CIC. 39 patients with liver cirrhosis of different degree were studied. CIC levels were determl~ ed by Con~lutinin-SolidPhase-Assay(CSPA) and by %SolidPhase-Assaywhich detects CIC of each immunoglobulin class(I~G-/IgA-/IgM-C3SPA). Hepatocytic function was evaluated b y m e a n s of Prealbumin (Pre), Albumin (Alb), Pseudocholinesterase (Pche) plasma levels and Prothrombin Time(PT). CIC levels above normal values (CSPA <44~; IEG-/I~A-/IgM-CSPA
RISK OF POST-TRANSFUSION INFECTION WITH THE HEPATITIS DELTA VIRUS 284
F. Rosina, G. Saracco, M. Rizzetto Division of Gastroenterology, Molinette, Torino Italy; S. Govindarajan, H. Alter,D.J. Gocke (USA), G. Papaevangelou (Greece), W.G. Schiller (GDR), C.A. Lee.(England)) J.P. Simonetti (Brazil), E. Penner (Austria), D. Tapalaga (Romania), G.V. Williams (Australia), G. Hess (GFR).
The most efficient mode of transmission of HBsAg associated hepatitis Delta Virus (HDV) is by direct parenteral inoculation with contaminated blood and blood products. To evaluate the prevalence of post-transfusion (PT) transmission of HDV from blood controlled for HBsAg, we measured antibody to HDV (anti-HD) in patients at risk. Anti-HD was found in 3.5% of 262 Italian, Greek and American patients, who suffered acute HBsAg-positive hepatitis after transfusion with blood. The prevalence of anti-HD was significantly higher in fulminant (4/28, 14.5%) than in benign hepatitis (5/234, 2%) (P<0.05). Based on a negative test for IgM anti-HBc, 3 of the 9 patients with hepatitis accompanied by anti-HD were identified as unrecognized carriers of HbsAg experiencing PT HDV superinfection. Anti-HD was found only in 3 of 94 Italian carriers of HBsAg multiply transfused with blood, in none of 34 Brasilian, East German, Rumanian and Australian haemophilic carriers infused with clotting factors prepared from single or mini-pool volunteer plasma, but in 27%-100% of European and US series including 79 haemophilic carriers treated with factors manufactured from pool of thosands of units of plasma. Screening of blood for HBsAg by third generation assays provides a high degree of safety in prevention of PT HDV infection. The minimal residual risk ~ i in 3.000 blood transfusions) is amplified in carriers of HBsAg. Carriers should be given only blood derivates prepared from single or mini-pool donors.
$320