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Positive tests for S. H. antigen were obtained from affected staff and patients of a haemoduialysis unit involded in an outbreak with clinical and epidemiological features of blood-borne hepatitis. In members of staff the test was positive in the early acute phase of the disease only. In patients on maintenance haemodialysis, however, the develoment of hepatitis was accompanied by strongly positive reactions which did not weaken significantly with the passage of time. In one patient the test was still positive after 3 years. These findings were consistent with epidemiological considerations which had already inciminated the blood of these patients as the vehicle for the causal agent of the outbreak, and suggest that a positive test for S. H. antigen in serum is related to the presence of hepatitis virus. It is not known why patients with chronic renal failure on maintenance haemodialysis continue, for long periods, to give positive reactions for S.H. antigen; but if this is associated with prolonged and heavy carriage of hepatitis virus it is clearly of serious significance in relation to extracorporeal-circulation techniques and renal transplantation. For this reason the test for S.H. or similar antigen should have a place in the management of these patients. |
