1035

virus or part of a virus, suggests a higher specificity of theleucocyte-migration test as a measure of cell-mediated

immunity in these subjects. As carbohydrates generallyconfer the distinct antigenic specificity of a virus, whilethe protein moiety more usually bears only commondeterminants to related viruses, the reaction to the carbo-hydrate moiety appears to be more specifically related toH.B. Ag. The protein moiety could then represent modifiedhost component(s) present in the virus and existing also inchronic liver disease brought about through specificmetabolic changes of alcohol in the liver.

Chicago Medical School,2020 West Ogden Avenue,Chicago, Illinois 60612,

U.S.A. MARIETTE J. GERBER.

SUDIN B. V. VITTALBERNARD F. CLOWDUS.

Hektoen Institute forMedical Research, andCook County Hospital,

Chicago, Illinois.

HEPATITIS-B ANTIBODY IN VOLUNTEER

BLOOD-DONORS

SiR,-We report here the result of the screening oflarge number of volunteer blood-donors for hepatitis-]antibody (anti-HBAg or HBAb). We examined sera fror2492 Red Cross volunteer blood-donors from the Washington, D.C., region for the presence of HBAb and found 10(4-2%) with detectable activity with titres from 1/5 t

> 1/6400 by means of passive hasmagglutination assa

(P.H.A.). Only 3 (0-012%) were demonstrable by counterelectrophoresis (C.E.P.), none by agar-gel diffusion (A.G.D.:By use of ’ Rheophoresis ’ kits, kindly supplied by DiJ. C. Holper, of Abbott Laboratories, we found 20 (0-8%donors with HBAb activity, all with P.H.A. titres > 1/16CLander et al.l reported that the frequency of antibod;

to HBAg among voluntary blood-donors measured bradioimmunoprecipitation (n.l.p.) test was 14-4%. It i

commonly believed that the technique of passive hasmagglutination assay 2 is just as sensitive as radioimmunoassay 3 for detecting HBAb. If this is so, the incidenceof HBAb among Red Cross volunteer blood-donors i:

distinctly lower than that found by them (4-2% as com.pared to 14-4%). Little is known as to the biologicaimplication of the presence of HBAb in normal individualsother than the presumption of past exposure to hepatitis-Eantigen.The results were:

Total no. ofdonor sera Total no. of sera

method tested with HBAb activityA.G.D. 2492 0C.B.P. 2492 3 (0-012%)

Rheophoresis 2492 20 (0-80%)P.H.A. 2492 106 (420%)

We wish to thank Dr. R. Krakaur and Dr. T. J. Greenwalt fortheir constructive suggestions and Dr. E. Stone for his kindnessin supplying the donor samples.

American National Red CrossNational Headquarters,

Blood Program Laboratory,1730 E Street, N.W.,

Washington, D.C. 20006, U.S.A.

LOUISA Y. NI

JANET SHOFFSHARI LAMA.

FREQUENCY OF HEPATITIS-B INFECTIONS

SiR,—Data are accumulating that hepatitis-virus-Binfections are far more common than the incidence ofhepatitis might indicate. Especially interesting in thisconnection are seroepidemiological surveys on the pre-valence of Australia antibodies. Radioimmunoassays have

1. Lander, J. J., Alter, H. J., Purcell, R. H. J. Immun. 1971, 160, 1166.2. Vyas, G. N., Shulman, N. R. Science, 1970, 170, 332.3. Walsh, J., Yalow, R., Berson, S. A. J. infect. Dis. 1970, 121, 550.

revealed high prevalence of these antibodies.1-3 Cherubinet al.3 have studied antibodies in different socioeconomicgroups in New York and have found a maximum pre-valence of 50% at 50 years of age among poorer classes,whilst the percentage among the more well-to-do is muchless-15%.Using a relatively simple radioimmunoassay method,4 4

we studied the prevalence of Australia antibodies in thepopulation of the Blood Bank of Ulleval Hospital in Oslowith the following results:

Age-group No. tested Percentage withantibodies

18-22 468 1-723-27 591 4-228-32 370 3-233-37 170 6-338—42 79 17-343-47 52 10-348-52 58 111

If the specificity of the test is confirmed, and we nowhave good reason to believe that it will be, these resultsseem to confirm the notion that virus-B infections are

very common even in a population of good hygienicstandard such as this. This means that testing for antibodieswith methods of high sensitivity is necessary to produceresults which are intelligible epidemiologically. With thistest, antibodies are regularly demonstrated after acute

infection except in cases where a permanent antigen carriercondition does develop. The high prevalence of theseantibodies does also possibly mean that new importantroutes of infection remain to be clarified.The low percentage among the young blood-donors

contrasts sharply with the figure obtained from youngnarcotic takers of Oslo, which is well above 70%.Medical Microbiological Laboratory,

Ullevål Hospital,Oslo 1, Norway.

J. C. ULSTRUPK. J. FIGENSCHOU.

MALIGNANCY ASSOCIATED WITH

ANTINUCLEAR ANTIBODIES

SIR,—Dr. Burnham (Aug. 26, p. 436) found a frequencyof positive antinuclear-factor (A.N.F.) tests in malignantdisease 19 times higher than in a blood-donor control group.We have screened sera of 100 patients with various histo-logically proven malignancies and found a positive A.N.F.test in 13:

Type of tumour No. of cases Positive A.N.F.

Lung cancer 46 6(15%)Cancer of stomach 13 3(23%)Cancer of larynx 29 1(3-6%)Others 12 3 (25%)Total 100 13

By comparison, in 500 sera sent to our laboratory forassessing A.N.F. in patients suspected of having variousconnective-tissue diseases, there were 103 (26%) positivesera. That apparently means that a positive A.N.F. test ishalf as common in patients with malignant disease as in agroup of patients most likely to be evaluated for A.N.F.In turn, it indicates that a positive-A.N.F. patient, in whomconnective-tissue disease has been excluded or not con-

firmed, should be thoroughly examined for malignantdisease.

It may be significant that all our cancer patients in whomA.N.F. was detected were at least in their fifties or older,

1. Walsh, J. H., Yalow, R. S., Berson, S. A. 13th International Con-gress of Hematology, International Society of Blood Transfusion,Aug. 6, 1970.

2. Lander, J. J., Alter, H. J., Purcell, R. H. J. Immun. 1971, 106,1166.

3. Cherubin, C. E., Purcell, R. H., Lander, J. J., McGinn, T. G.,Cone, L. A. Lancet, July 22, 1972, p. 149.

4. Figenschou, K. J., Ulstrup, J. C. Unpublished.