Australia antigen in chronic hepatitis in Australia

Of 53 cases of active chronic liver disease two were found to be carriers of Australia antigen Au (1)-an elderly woman with typical lupoid hepatitis and an elderly mortuary attendant with serologically atypical active chronic hepatitis. Au (1) was detected also in the serum of 7 out of 20 patients with clinically atypical acute hepatitis-one was an elderly Italian woman, one had hepatitis in the puerperium, and five had a history of transfusion or inoculation. The antigen was not found in 20 typical cases of infectious hepatitis in young people in 86 patients with other diseases. Antibody to Au (1) was present in only 2 out of 102 patients who had received numerous transfusions.We conclude, firstly, that Au (1) antigen is rare in white Australians (in keeping with the low incidence of serum hepatitis in Australia), and, secondly, that Au (1) positivity in hepatitis patients is associated with transfusions and with older age. We suggest that active chronic hepatitis and lupoid hepatitis may follow infection of susceptible individuals with Au (1)-positive hepatitis virus, but persistence of the virus in high titre does not appear to be necessary for chronicity of the disease.