The prevalence of Australia-antigen and -antibody was studied in 196 patients with thalassaemia, aged 10 months to 14 years. Au-Ag was detected in 14 patients (7%) and Au-Ab in 63 (32%). The prevalence of Au-Ag was in inverse relation to the age of the patients and in direct relation to the number of units of transfused blood. By contrast, the prevalence of Au-Ab was directly related to both the age and the number of transfused blood units. Au-Ab was detected in 61% of patients who had received more than 60 units of blood, but in only 11% of patients who had received less than 20 units. No sex difference was found in the prevalence of Au-Ag and Au-Ab.
Only 2 patients with Au-Ag were without clinical or biochemical evidence of hepatitis; in all the remaining 12 patients Au-Ag persisted throughout the period of observation of from 5 to 18 months. During the same period Au-Ab was found to persist in all patients in whom it was detected.
The persistence of Au-Ag and the synthesis of Au-Ab appear to be related to (a) repeated infection with type B virus and (b) the host's immune response.
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