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Parenterally transmitted non-A, non-B hepatitis: an epidemic reassessed

J D Meyers, J L Dienstag, R H Purcell

    Annals of Internal Medicine
    |July 1, 1977
    PubMed

    Insights

    This 1972 hepatitis outbreak was initially attributed to Hepatitis A (HA) virus. However, re-examination using advanced serology confirmed no HA virus infection, challenging previous assumptions about post-transfusion hepatitis causes.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Transfusion Medicine

    Background:

    • A 1972 outbreak of parenteral hepatitis occurred in an oncology unit, affecting marrow transplant patients and platelet donors.
    • The illness, characterized by a 27-day incubation period and response to immune serum globulin, was initially presumed to be Hepatitis A (HA) virus infection.
    • Initial serologic tests ruled out Hepatitis B virus (HBV) and cytomegalovirus (CMV) infections.

    Purpose of the Study:

    • To re-examine stored serum samples from the 1972 hepatitis outbreak using modern serologic techniques.
    • To definitively determine the causative agent of the outbreak, specifically investigating for Hepatitis A (HA) virus infection.

    Main Methods:

    • Stored serum samples from patients and donors involved in the 1972 outbreak were tested.
    • Advanced serologic assays were employed to detect antibodies against the Hepatitis A (HA) virus.
    • Serum samples were analyzed for pre-illness and convalescent titers to assess for seroconversion.

    Main Results:

    • None of the ten patients and donors with undetectable pre-illness anti-HA titers showed seroconversion.
    • Five individuals with pre-existing anti-HA titers did not exhibit a significant rise in antibody levels during convalescence.
    • One patient's serum sample was deemed inevaluable for HA virus infection.

    Conclusions:

    • The re-examination conclusively demonstrated the absence of Hepatitis A (HA) virus infection in the 1972 outbreak.
    • This finding indicates that most post-transfusion hepatitis cases are not caused by Hepatitis A (HA) or Hepatitis B (HB) viruses.
    • Short-incubation-period hepatitis should not be automatically assumed to be Hepatitis A (HA) without thorough serologic investigation.

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