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SUMMARYThe indirect immunofluorescent technique has been used to study the specific immunoglobulin responses in twelve adult cases of acute uncomplicated rubella. IgG, IgA and IgM antibodies increased virtually simultaneously. IgG antibody persisted throughout the period of study but showed a slight tendency to fall in titre after 7 months. IgM antibody was detected in nine cases. In these patients it was present in high titre 5-15 days after the rash but was not detected after 20 days. IgA antibody was detected in all cases. It was present in high titre 5-20 days after the rash but was no longer detectable after 29 days except in one patient who had a very low titre at 78 days. The presence of specific IgA and IgM indicates recent rubella in uncomplicated cases, and if the immunofluorescent method is used both types of antibody should be sought.

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The use of urine as a noninvasive specimen for the diagnosis of hepatitis A (HAV) and hepatitis B (HBV) virus infections was investigated. Specimens of urine were collected at the same time as blood or saliva specimens, or singly in cases of previously serologically confirmed recent infection. The specimens were tested for IgG and IgM anti-HAV and anti-HBc by immunoglobulin class-specific capture radioimmunoassays (GACRIA and MACRIA). On the basis of assays on urine specimens it was possible to distinguish between individuals who were susceptible or immune to HAV or who had recently been infected with HAV. Using assays on 327 corresponding saliva specimens as reference tests, the observed sensitivity and specificity of tests on urine specimens by anti-HAV GACRIA were 98.9% and 99.1%, respectively, and by anti-HAV MACRIA were 95.8% and 99.6%, respectively. IgM and IgG anti-HBc were detected readily in the urine of 35 acute or recent cases of hepatitis B but were not found in the urine of seronegative individuals. Of the urine specimens from 52 individuals who were HBsAg carriers or who had had long past HBV infections, 49 contained detectable IgG anti-HBc. Of urine specimens from 42 HBsAg carriers, 11 contained raised IgM anti-HBc levels. Urine, which is a convenient specimen to collect, can be used to study outbreaks of hepatitis A, to ascertain the HAV immune status of individuals, to differentiate hepatitis A from hepatitis B, and to identify individuals who have been naturally exposed to HBV.

IntroductionThe earlier in life that infection with hepatitis B virus occurs the greater the possibility that it will lead to persistent carriage, which greatly increases the risk of cirrhosis or primary hepatic carcinoma in later life. 2 More than 80% of infants whose mothers are carriers of the hepatitis B surface antigen and also have the hepatitis B e antigen (a serological marker of high infectivity) become persistent carriers. This outcome is less common when the mother is negative for the hepatitis B e antigen and its antibody and rare if she is positive for antibody to hepatitis B e antigen.3In Britain the prevalence of carriers positive for hepatitis B surface and e antigens among female blood

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Antibody to human T lymphotropic virus type 1I1 (anti-HTLV-III)

SUMMARYA retrospective survey of transfusion hepatitis associated with a brand of commercial Factor VIII was carried out in 24 Haemophilia Centres from January 1974 until December 1975. Of 371 patients who were transfused with this product, and were followed up, 78 cases of hepatitis affecting 66 patients were found (17-7 %). Two types of hepatitis were observed: hepatitis B and non-B hepatitis, the latter with an incubation period of between 8 and 60 days. Twelve patients contracted two types of hepatitis, non-B followed by hepatitis B. Only one patient died after contracting hepatitis B. Four of the suspect batches of concentrate were found to be positive for HB.Ag by radioimmunoasay.There was evidence that the presence of hepatitis B surface antibody in a patient's serum prior to exposure was amsociated with immunity to hepatitis B. Evidence was presented suggesting that the non-B hepatitis observed was not due to hepatitis A. The factors affecting the incidence of transfusion hepatitis in haemophiliacs were discussed.