MGH Test Will Boost Detection of Hepatitis B

Doctors at Harvard-affiliated Massachusetts General Hospital (MGH) have developed a new test which they say will "significantly improve" their ability to identify donor blood carrying hepatitis B, a severe viral infection of the liver.

The test also allows diagnosis of hepatitis, as well as of some cases of acute and chronic cirrhosis.

Hepatitis B, also known as scrum hepatitis, usually strikes adults, can cause cirrhosis, and is more severe than hepatitis A. Chronic carriers of the virus have a greater than normal chance of developing liver disease and cancer of the liver.

Ten different strains of hepatitis B infect about 250 million people worldwide, and the new test can identify all of them, said Dr. Jack F. Wands, who headed the research.

Although a test for hepatitis B currently exists, it is "nowhere near as sophisticated as this one," a spokesman for the hospital said yesterday. He added that the new procedure is at least several times more efficient than the current one.

The study also showed that the virus stays in the blood far longer than was previously thought, causing carriers to transmit it even after they are thought to be risk-free.

"This fact is important in dealing with blood donors, dialysis patients, and those in close contact with hepatitis patients," Wands said.

Wands, an assistant professor of medicine at the Medical School, has spent several years developing the test, which uses highly specific antibodies, called monoclonal, to identify the virus.

"It's a more specific antibody than [the ones used in the] general tests we have now. It has to be prepared, it requires special techniques," said a doctor in the gastrointestinal division of nearby Brigham and Women's Hospital (BWH), which is also Harvard affiliated.

He declined to be identified because the study has not yet been made widely public. Wands and his team will present their findings to an international symposium today in San Francisco.

The FDA requires doctors to screen all donor blood for the virus before transfusion.

Monoclonal antibodies are hybrid cells, made up of antibody-producing cells fused with malignant ones. The hybrid cells can be cloned, allowing them to keep producing antibodies necessary to detect the virus.

The monoclonal are unique because they are specifically designed to identify the hepatitis B virus and can be produced in unlimited quantities, Wands said.

Last Resort

Although transplants often serve as a last resort in treating liver diseases, the BWH doctor said that the new test is unlikely to reduce the number of transplants performed, because hepatitis B infections are "a relative contraindication to transplants."

He added that it will probably not be economically feasible for doctors to use Wands's test routinely, because the manufacture of monoclonal antibodies is expensive However, he said, if funds were available, perhaps from the government, the impact of the discovery could become far greater than it now is