Between 5 and 10% of adults infected with the hepatitis B virus (HBV) develop a chronic infection lasting longer than 6 months, which may lead to advanced liver disease. HBV can be classified into six genotypic families: A, B, C, D, E and F, but only genotypes A and D are significantly represented in western Europe, where they account for some 90% of cases of infection with HBV. In the present study, we investigated a possible association between HBV genotype A or D and clinical outcome of the infection. We compared the prevalence of these genotypes in a group of patients with chronic active hepatitis to that of a group with acute resolving hepatitis. In patients with chronic active hepatitis, genotype A was found in 28 of 35 patients and genotype D in only four. The remaining three patients were infected with genotype non-A, non-D. In contrast, genotype D was found in 24 of 30 patients with acute hepatitis, whilst genotype A was found in only three patients of this group. Three were infected with genotype non-A, non-D. Our results show a clear association between genotype A and chronic outcome (Ficher's exact test: two-sided P-value, P < 0.0001). They suggest that HBV genotypes may play a role in the virus-host relationship. Possible mechanisms for such a role are discussed.

Serum samples from 274 patients allergic to one or more of three pollens (birch, grass, mugwort), from 36 patients allergic to cat and/or Dermatophagoides pteronyssinus but not to pollen and from 55 non-allergic controls, as well as 20 cord blood samples, were examined for specific IgE to six 'pollen-associated' food allergens by using a new sensitive assay (CAP). A questionnaire asking for reactions to food was also sent to all patients. In the pollen group, 111 patients (47%) were positive (> or = 0.71 kU/l) for a food allergen (392 positive tests). Of these, 92 were sensitive to apple, 68 to potato, 64 to carrot, 63 to celery, 61 to peach and 44 to melon. In the non-allergic group, no IgE to any of the food allergens tested was found, whereas in the group allergic to non-pollen allergens, only one individual had such an IgE. The CAP assay was found to be more sensitive than RAST for the allergens studied. A history of clinical reactions (oral symptoms in 67, rhinoconjunctivitis in 65, asthma in 42 and urticaria in 39) to the corresponding food allergen was reported mainly by patients with positive CAP. In conclusion, we found a high prevalence of IgE to some food allergens in patients allergic to pollen and the absence of such antibodies in the control groups. The new in vitro assay, being more sensitive than previous ones, indicated a high prevalence of food specific IgE in pollen allergic patients, which in many cases did not correspond to clinical symptoms of food allergy.

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CD28 is a transmembrane glycoprotein that provides T cells with an essential co-stimulatory signal during antigen presentation. Using flow cytometry, we document here an expansion of CD28- T cells in HIV infection. Whereas the percentage of CD4+CD28+ T cells among total lymphocytes was decreased, a small increase of the percentage of CD4+CD28- T cells was observed. In the CD8+ subset, there was a marked expansion of CD8+CD28- T cells. An increased percentage of CD8+ T cells positive for HLA-DR was found in both CD28+ and CD28- cells. Results were similar for CD38 expression. HIV infection was also distinguished by a shift from LFA-1lowCD28low to LFA-1highCD28high and LFA-1high-CD28neg expression pattern on CD8+ T cells. Negative correlations were found between percentage and absolute number of CD8+CD28+ T cells and several serum parameters usually associated with poor prognosis (IgA, IgE, beta 2-microglobulin and HIV-1 p24 antigen). Thus, HIV infection is characterized by a marked expansion of CD28- T cells with an abnormal expression of activation markers and cell adhesion molecules. In addition, CD8+CD28+, but not CD8+CD28- or total CD8+ T cell numbers, correlated with the levels of established serological markers of disease severity or progression and may, therefore, have predictive value.