Subtypes of Australia Antigen among Patients and Healthy Carriers in Copenhagen

Abstract

The D (ad +, y-) and Y (ay +,d-) subtypes of Australia antigen were determined in 199 antigen-positive patients with various liver diseases and 23 healthy carriers. In 183 consecutive patients with biopsy-verified acute viral hepatitis, the antigen was the Y subtype in 79 per cent and the D subtype in 21 per cent. A similar subtype distribution was found in patients with biopsy-verified chronic hepatitis and persistent antigenemia. In contrast, all 10 patients with cirrhosis and all the healthy carriers had antigen of the D subtype. A striking epidemiologic difference was found, in that 98 per cent of the drug addicts had the Y subtype, whereas the D subtype predominated in the "sporadic" cases. The acute disease in the 183 patients with acute hepatitis was more severe in the group of patients with antigen of the D subtype, as judged by both histologic and biochemical criteria. Thus, the different subtypes of Australia antigen are associated with particular epidemiologic and clinical features of acute hepatitis, as it is seen in Copenhagen. (N Engl J Med 288:1257–1261, 1973)