Asymptomatic Carriers of Australia Antigen

R. 1. RUSSELL AND J. G. ALLEN (Royal Infirmary, Glasgow), R. N. M. MACSWEEN (Western Infirmary, Glasgow), AND J. WALLACE (Glasgow and West of Scotland Regional Transfusion Centre) Thirty-nine blood donors found to be Australia antigen or antibody positive were studied for evidence of hepatic disease. Twenty donors gave a history of possible exposure to infection with viral hepatitis. Seven had severe and five had minor biochemical abnormalities; eight ofthese 12 subjects had Australia antigen and four antibody; 23 subjects had normal biochemistry. Of 11 donors who underwent hepatic biopsy, three were found to have evidence of chronic persistent hepatitis. Two of these three had antigen and one had antibody. Minor histological abnormalities were found in a further five donors. Five donors with normal biochemistry were biopsied, and one of these was found to have chronic persistent hepatitis. The results suggest that subjects with persistently positive tests for Australia antigen are at risk of developing chronic hepatic disease, and that those with positive tests for antibody are at similar risk. Close follow up of blood donors and other subjects found to have positive tests is thus indicated. Although abnormalities in biochemistry may be present in such subjects, normal biochemical tests do not exclude abnormal hepatic histology. Conventional 'liver function tests' were of little value, and all other antibody tests yielded negative results. Serum enzymes were far the most sensitive indices of probable hepatic involvement, aspartate transaminase, isocitrate dehydrogenase, glutamate dehydrogenase, and adenosine deaminase being the most useful of the eight enzymes studied.