A Prospective Study of Posttransfusion Hepatitis

Abstract

Transfusion of blood containing Australia antigen (Au) was followed by development of hepatitis, Au antigenemia, or both in 52% of recipients. Another 23% of Au recipients exhibited an immune response. However, transfusion of Au-negative blood was associated with anticteric hepatitis in 16% and icteric hepatitis in 2% of the recipients. The typical Au recipient with hepatitis was Au positive during the acute phase and had a severe clinical illness. In the recipient of Au-negative blood, hepatitis was characterized by Au-negative tests in the acute phase and a mild illness. On the basis of these data, estimates of the relation of Au to the overall problem of posttransfusion hepatitis suggest that Au accounts for approximately 25% of icteric cases. Twenty percent of patients who developed Au antigenemia following transfusion became carriers of the antigen. Patients who became Au carriers tended to have mild or anicteric hepatitis, while those with severe, icteric attacks reverted to the Aunegative state. The frequency of Au antigen in commercial donor blood was 13-fold greater than in volunteer blood.