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Polyclonal integration of HTLV-I proviral DNA in lymphocytes from HTLV-I seropositive individuals: an intermediate state between the healthy carrier state and smouldering ATL.

We have studied 15 individuals (aged 14-74 years) with antibodies to HTLV-I in their serum and random integration of HTLV-I proviral DNA in their peripheral blood lymphocytes. All but one of these patients suffered from a variety of non-specific complaints which did not correspond to those of adult T-cell leukemia (ATL). All of them were born in Kyushu and Okinawa which are endemic areas for HTLV-I infection; 25% of their family members were also seropositive for HTLV-I. The only haematological abnormality in these patients was the presence of few atypical lymphoid cells in the peripheral blood. The CD4/CD8 ratios were normal but the proportion of Tac positive cells was slightly higher than normal. These individuals with polyclonal integration of HTLV-I proviral DNA seem to represent an intermediate state between smouldering ATL (monoclonal integration) and healthy HTLV-I carriers (with antibodies but no detectable HTLV-I proviral DNA). Patients with this intermediate state of HTLV-I infection may be at risk to progress to ATL. The natural history of HTLV-I infection in humans leading to the development of ATL is reviewed in the light of these new findings.

Adolescent

Salmonella carrier state and biological characteristics of the infectious agent.

Salmonella carrier state (42.6%-S. enteritidis and 34.4%-S. dublin) was demonstrated in subjects after acute salmonellosis as well as in healthy persons infected with salmonella as a result of occupational exposure to poultry (8.8% in humans exposed to chickens and 6.1% in those exposed to ducks) and sheep (2.8%). The carrier state was accompanied by intermittent pain in the epigastrium, diminished appetite, diarrhoea etc. Most of the carrier subjects with a history of salmonellosis exhibited, upon rectoromanoscopy, a varying degree of proctosigmoiditsi. The etiological role of S. typhimurium was proved beyond doubt, as well as its ability to cause salmonellosis outbursts, sporadic cases of the disease and the carrier state. When large industrial facilities specializing in poultry processing were investigated, the salmonella carrier state was revealed in practically healthy poultry--in 16% of chickens and 12% of ducks. The salmonella organisms isolated from carrier persons had, with some exceptions, typical properties, being virulent in that they caused death of experimental animals, seeded their internal organs and induced pathogenicity-associated enzymes. Multiple resistance to antibiotics was demonstrated in salmonella isolated from poultry; also determined was its plasmid nature. Pronounced resistance of the above salmonella subtypes to tetracycline-related antibiotics and streptomycin may be due to the fact that these drugs are used in poultry raising.

Agricultural Workers' Diseases

[Epidemiological and laboratory criteria in the assessment of meningococcus carrier state].

A study was made of the duration of meningococcus carrier state, immunological indices and group-specific properties of meningococci isolated from them. The periods of meningococcus discharge were studied in 738 persons. Three categories of the carrier state were revealed: a single discharge (67% of the carriers), of average duration (up to 4 weeks), and prolonged. Greater indices of group-specific antibodies (in the passive hemagglutination test) were revealed in the carriers with prolonged presence of meningococci in the nasopharynx. Dynamics of immunological indices and periods of the carrier state formation in the foci of infection permitted to characterize the prolonged carrier state as a latent form of meningococcus infection. A study of the group-specific properties in 1845 strains and comparison of the group-specific pattern of the circulating strains with the epidemic situation indicated that meningococci of group A were not only epidemic, but also more virulent.

Adolescent

[The vaccinal prevention of the HBsAg carrier state among newborn infants].

The paper presents the data on the time course of HBsAg carrier state in babies born to mothers with antigenemia indicating the dependence of the pattern of the antigen carrier state in babies upon the time of its primary detection. The stable (chronic) HBsAg carrier state in babies was shown to be formed after the first 3 months of life which attests to the necessity of using a vaccine against hepatitis B (HB) for prevention of HBsAg carrier state in newborns. The results of epidemiological survey in 185 babies developing HB with the analysis of all possible factors of their infection contraction are presented. The efficacy of the national plasma vaccine against hepatitis B is evaluated in observations of the newborn babies whose mothers were carriers of HBsAg. It was established that in vaccinated babies after 3 injections of the vaccine at 0, 1, and 6 months the rate of antigen detection was 3.3% and that of antibody 80% whereas in babies of the control group these values were 23.7% and 8.0%, respectively.

Asia, Central

[Meningococcal carrier state and meningococcal diseases in a military unit].

In four recently formed military units pharyngeal meningococcal carrier state and dynamics of nasopharyngeal meningococcal infections have been examined. Carrier state found in at least 50% of recruits at their entering the army has been increased during the first two months for 10-26.4% and it was associated with very significant dynamics of meningococcal infection: changes in carrier state during the first two months have been found in 61.3% of soldiers with very marked changes in distribution of some meningococcal serologic groups among isolated species. Two months later stagnation and lower percentage of the carrier state was observed together with reducing dynamics of meningococcal infection. Meningococcal disease did not occur in the examined environment and this was explained by the absence of virulent meningococcal serotypes. It was concluded that in the risk for meningococcal disease evaluation final identification of meningococcal species isolated from patients and their contacts should be made aiming to timely detection of species known to have significant degree of virulence.

Bacterial Infections

[Importance of humoral immunity indices in determining the Rickettsia prowazekii carrier state].

Experiments showed the possibility of making indirect conclusions concerning rickettsial carrier state by the method of determination of complement-fixing antibodies to R. prowazeki in the blood serum. Though not indicative of carrier state in individual animals, these antibodies, their dynamics and titers gave the evidence of group carrier state in cotton rats in respect of the causative agent of typhus. The number of animals carrying R. prowazeki increased with the rise of antibody titers. Negative seroconversion indicated the elimination of the causative agent from the body of the animal. The experimental results were confirmed by the data on the dynamics of the immunological structure of population, as well as by information contained in the literature on this problem.

Adolescent

[Relationship of serum streptococcal antibodies to carrier state of beta-hemolytic streptococcus in throats of healthy schoolchildren].

The relationship of ASO, ASK and ASP to carrier state of beta-hemolytic streptococcus in throats of healthy schoolchildren was examined from September, 1980 to May, 1987. The responses to ASO significantly increased in children who detected group A, C and G streptococcus, and ASK in group A and G, and ASP in group A. The responses were especially high in children who detected group A, C and G streptococcus one after the other through the term of research, and in children detected another T type of streptococcus one after the other. Relatively high titers of ASO and ASK were obtained in sera of children from whom some groups or T types of streptococci were isolated several detection times. ASP titers were not concerned with these times. The elevation of antibodies in paired samples were found as follows; 7 cases in ASO, ASK and ASP together, 42 cases in ASO and ASK together, 3 cases in ASK and ASP together, 2 cases in ASO and ASP together, 41 cases ASO only, 38 cases in ASK only, 7 cases in ASP only. Among these cases with elevation of antibodies titers, several kinds of the change of streptococcal carrier state were observed between obtaining serum of twice. Especially 15 cases with change of carrier state from group A to group A were noticed. Among these 15 cases, 11 cases isolated another T type strain through the term of research, or found to contain the research-time when no streptococcal strain was detected. Both long term carrier state of the same group or the same type of streptococcal strain and change of carrier state of streptococcal group or T type lead the elevation of ASO and ASK titers.

Antibodies, Bacterial

Clinical and epidemiological significance of the HBSAg (Australia antigen): carrier state.

One hundred fifteen asymptomatic Australia antigen (HBSAg) carriers, discovered by routine testing of volunteer blood donors in Toronto, were investigated and followed for up to 30 months. The carrier state seems to be largely host-dependent, and its prevalence is modified by ethnic origin, sex, and age. A high prevalence of carriers was found in persons coming from Mediterranean countries and the Orient. The carrier state was 3 times more common in males than in females, and the majority of the carriers were under 30 years of age. Family clustering of HBSAg-positive individuals was observed. All carriers were asymptomatic and only one gave a history of jaundice in the past. Seven gave a history of intravenous drug use. Four had moderate hepatomegaly. Fifty-four had some abnormality in their liver function tests. The SGPT was the most frequently abnormal test and correlated best with the histological findings. Twenty of 29 liver biopsies showed features of chronic benign persisting hepatitis. All patients remained well during the follow-up period. In no patient was there evidence of deterioration or progression in either their clinical state, liver function, or pathological findings. Only 1 of the 115 carriers became HBSAg-negative over the period of observation.

Adult

Chemotherapy of East Coast fever: the long term weight changes, carrier state and disease manifestations of parvaquone treated cattle.

The weight changes, carrier state and nature of chronic disease in cattle following infection with five isolates of Theileria parva and treatment with parvaquone were studied over an 18 month period while the cattle were maintained on normal management under strict tick control. Cattle infected with the T.p. parva Pugu II isolate gained weight similarly to uninfected control cattle and did not develop a detectable carrier state or show chronic disease. The cattle in the 4 other isolate groups regained the weight lost during the initial infection more slowly, then gained weight in parallel to the control cattle. Transmission of infection through ticks was achieved consistently from the T.p. parva Mbita I and Entebbe II isolate infections and intermittently from the T.p. lawrencei Mara II and Manyara infections. Infections were transmitted from cattle which had neither a detectable parasitaemia nor an antitheilerial antibody titre. Persistent macroschizont parasitoses were detected with the T.p. parva Entebbe II and the two T.p. lawrencei infections. The histopathology of the chronic disease lesions is described and the importance of the carrier state discussed.

Animals

[Combined passive and active immunization for preventing the development of the infantile carrier state in hepatitis B virus vertical transmission].

By applying hepatitis B (HB) immunoglobulin (HBIG) and HB vaccine (vaccine) to 43 infants born to HB e antigen (HBeAg)-positive HB surface antigen (HBsAg) carrier women intramuscularly, and sub-and/or intra-cutaneously, respectively, the clinical usefulness of combined passive and active immunization in preventing infantile development of the carrier state was evaluated. The results obtained in this study are summarised as follows: Of the 43 infants, 5 (11.6%) developed the carrier state and 38(88.4%) were persistent HBsAb-positive. This carrier-rate was found to be significantly lower than that of 78 non-treated infants (73.1%) born to HBeAg-positive carrier women (control). Four of 15 infants (26.7%), who received HBIG every 4 months, developed carrier state, while only one case (3.6%) fell into carrier state in 28 infants who received HBIG every 3 months. In 30 infants whose vaccination was started at 2 or 4 months of age, 93.3% of the cases became persistent HBsAb-positive within 12 months, while 76.9% of 13 infants who underwent the first vaccination at 12 months of age became persistent HBsAb-positive. No adverse effects of HBIG and HB vaccine were observed in this study. In addition, the mean values for serum glutamic pyruvic transaminase (SGPT) were 35 and 69mu/ml in the treated and control groups, respectively. Thus, the present study demonstrates that the infantile development of HBsAg carrier state by HB virus-vertical transmission could be safely, economically and easily prevented by early initiation of vaccination and re-administration of HBIG within 3 months.

Carrier State

Prevention of hepatitis B virus carrier state in infants according to maternal serum levels of HBV DNA.

235 infants of HBeAg-carrier mothers in Hong Kong were assigned to four study groups. Groups I, II, and III received hepatitis-B (HB) vaccine at birth and at 1, 2, and 6 months. Group I also received seven monthly injections of HB immunoglobulin (HBIg), and group II received one HBIg injection at birth. Group III received vaccine only and group IV received placebo for both vaccine and HBIg. At the age of 3 years, all infants of the three treatment groups were significantly protected against the HB virus (HBV) carrier state compared with the placebo group (p less than 0.0001); the protective efficacy rates in groups I, II, and III were 87%, 80%, and 65%, respectively. At all times, group I was significantly better protected than group III. In groups III and IV, infants of mothers with serum HBV DNA levels of 5 pg/ml or above were at a significantly higher risk of acquiring the HBV carrier state than those whose mothers had HBV DNA levels below 5 pg/ml. This difference was not significant in groups given HBIg. Of the 183 infants who initially escaped HBV infection, 73 (40%) had transient and 8 (4%) chronic HBV infection between 6 and 36 months. Vaccinated infants who had actively formed anti-HBs remained well protected against the HBV carrier state. However, infants in groups I and II with no active anti-HBs response to vaccine became at risk for the HBV carrier state when the passively acquired anti-HBs antibodies had disappeared. HBIg should be included in HB vaccination schedules for all infants of HBeAg-positive mothers.

Age Factors

Background and practical aspects of hepatitis B surface antigen carrier state.

The prevalence of hepatitis B surface antigen (HBSAg) carriers in the Europe and North America 0.1 - 0.2%, but can exceed a few per cent in South-East Asia and Africa. The HBSAg carrier state is considered to be connected with sociaohygienic conditions but it is evident that genetic factors also contribute the chronic carrier state. Practical measures concerning the treatment and management of HBSAg carriers are discussed.

Age Factors

Demonstration of the carrier state in naturally acquired equine arteritis virus infection in the stallion.

The chronic carrier state was virologically confirmed in 15 thoroughbred stallions naturally infected with equine arteritis virus based on the results of test matings and, or, isolations of the virus from semen. Carrier stallions were shown to shed equine arteritis virus in the semen for at least one to two years. Existence of a short-term or convalescent carrier state was also demonstrated in five additional stallions. The frequency of the long-term carrier state in stallions naturally infected with equine arteritis virus was 35 per cent; it varied considerably between groups of stallions on different farms. The carrier stallion would appear to play an important epidemiological role in the dissemination and perpetuation of equine arteritis virus.

Animals

The carrier state in equine arteritis virus infection in the stallion with specific emphasis on the venereal mode of virus transmission.

The carrier state has been confirmed virologically in Thoroughbred and non-Thoroughbred stallions naturally infected with equine arteritis virus (EAV). Short-term or convalescent and long-term carriers occur. The frequency rate of the long-term carrier state in Thoroughbreds was high, averaging 33.9% among the three groups of stallions under study. While the convalescent carrier state only lasted a few weeks after clinical recovery, the long-term carrier state could persist for years. There was evidence, however, that not all such carriers might remain persistently infected for life. Carrier stallions appeared to shed EAV constantly in the semen but not in the respiratory secretions or urine. It also could not be demonstrated in the buffy coat of the blood. All of the carrier stallions have continued to maintain moderate to high neutralizing antibody titres to EAV in serum. Virus was associated with the sperm-rich and not the pre-sperm fraction of semen. There was relatively little variation in virus concentration between sequential ejaculates from the same stallion. Transmission of EAV infection by long-term carrier stallions would appear to occur solely by the venereal route. Such carriers are thought to play an important epidemiological role in the dissemination and perpetuation of the virus.

Animals

Age- and sex-related study of hepatitis B virus chronic carrier state in infants from an endemic area (Senegal).

This report concerns hepatitis B virus (HBV) infections observed in 155 infants from Senegal, studied with a view to determining the factors involved in development of the chronic carrier state. A chronic carrier state was observed in 50.3% of the infants. This study confirms that the risk of chronic carriage is linked to age. This risk declines very rapidly with age, falling from 82% in infants under 6 months old, to 15% in children between the ages of 2 and 3 years. Spontaneous elimination of hepatitis B surface antigen (HBsAg) is uncommon in HBsAg carriers during childhood. The difference observed in chronic carriage between males and females is due to a difference in susceptibility of the two sexes to the development of the chronic carrier state: HBV infections (before 2 years of age) lead to a chronic carriage in 77% of males as against 50% of females. These conclusions are important in view of the immunisation programs being carried out against hepatitis B virus in endemic areas. For a maximum efficacy, vaccination must be carried out at birth, or shortly afterwards.

Age Factors