Pathogenesis of posttransfusion viral hepatitis in children with beta-thalassemia.
The pathogenesis of posttransfusion hepatitis was determined in 14 children with beta-thalassemia. All had blood samples obtained in 1980 or 1981, were vaccinated against hepatitis B virus in 1983 and had another serum sample collected in 1989. Seven children had detectable antibodies against hepatitis C virus before vaccination, and all were positive in 1989. With specific solid-phase enzyme immunoassays, all children had antibodies against hepatitis B virus, X and polymerase antigens in 1981, and six had one or both antibodies in 1989. Hepatitis B virus infection was confirmed by means of polymerase chain reaction, which demonstrated virus DNA in 13 of the 14 children. The amplification products spanning the X/precore region were smaller than expected, suggesting mutations in this region. Cloning and sequencing of these products revealed deletions spanning part or all of the X gene. The results show that these children were infected with hepatitis B virus even without other markers in serum, that hepatitis B persists years after vaccination and that such infections are associated with the presence of X deletion mutants. Coinfection with hepatitis B and C viruses, the former containing a new class of variants, is common in children with beta-thalassemia.
Feitelson
M
M
Department of Pathology and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Lega
L
L
Guo
J
J
Resti
M
M
Rossi
M E
ME
Azzari
C
C
Blumberg
B S
BS
Vierucci
A
A
D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D005260:Female; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D006525:Hepatitis, Viral, Human / Q000201:enzymology / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000150:complications; D008297:Male; D015335:Molecular Probes / Q000235:genetics; D008969:Molecular Sequence Data; D015534:Trans-Activators / Q000032:analysis; D065227:Transfusion Reaction; D054334:Viral Regulatory and Accessory Proteins; D017086:beta-Thalassemia / Q000150:complications / Q000276:immunology / Q000628:therapy*
D006508:Hepatitis Antibodies; D015335:Molecular Probes; D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins; C057628:hepatitis B virus X protein