N. RAPHAEL SHULMAN, M.D.; RICHARD J. HIRSCHMAN, M.D.; LEWELLYS F. BARKER, M.D.
A virus-like antigen in many patients with acute hepatitis may be transmissible by inoculation or ingestion of blood or blood products. The severity of the resultant hepatitis may depend partly on the dose of the hepatitis-associated antigen. The antigen appears in the blood before signs or symptoms of acute hepatitis, and in about 7% of cases remains for an indefinite period after recovery. Although no test is as yet sensitive enough to detect the lowest levels of antigen (and presumably virus) that are infectious, the agar-gel-precipitin test detects the antigen in 0.1 to 0.5% of normal American blood donors. Anticomplementary activity in sera of some hepatitis patients and blood donors may be caused by the antigen in combination with antibody and may be the only manifestation of the carrier state. Since the antigen has not been found in several outbreaks of short-incubation infectious hepatitis but has been found in many isolated cases diagnosed as infectious hepatitis, it is likely that similar clinical manifestations are produced by more than one virus group.
SHULMAN NR, HIRSCHMAN RJ, BARKER LF. Viral Hepatitis. Ann Intern Med. 1970;72:257–269. doi: 10.7326/0003-4819-72-2-257
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Published: Ann Intern Med. 1970;72(2):257-269.
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