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Statement of the ad hoc committee on the laboratory diagnosis of infectious and serum hepatitis.

The Ad Hoc Committee on the Laboratory Diagnosis of Infectious and Serum Hepatitis convened by the Department of National Health and Welfare met on March 24, 1970, at the Canadian Communicable Disease Centre in Ottawa. The main objectives of this meeting were to review recent developments in hepatitis research, discuss problems related to the association of the so-called "Australia antigen" with human viral hepatitis and formulate plans for the preparation and standardization of diagnostic reagents to be made available for use in Canadian virus laboratories. The Australia antigen was discovered by Blumberg et al.1 in the serum of an apparently healthy Australian aborigine, when it reacted in the agar-gel precipitation test with the serum of a multiple transfused hemophiliac. Following the demonstration by Blumberg and his group that the Australia antigen was associated with cases of viral hepatitis, the literature on the subject has been almost overwhelming. Similar antigens have been described by others2'3 and found to be associated either with serum hepatitis only or with both forms of viral hepatitis (infectious and serum hepatitis). Evidence suggests that the Australia antigen represents the protein component of a virus-like particle considered to be a possible causative agent of human viral hepatitis. The presence of this antigen in the blood (serum or plasma) of an affected individual can be detected by established laboratory techniques with varying degrees of efficiency. Until very recently, the need to employ a suitable antiserum of human origin for the detection of the antigen in specimens has necessarily limited the scope of such investigative work. With the demonstration by Purcell et al.4 that highly potent antiserum can be prepared in guinea pigs hyperimmunized with purified antigen, it is apparent that means now exist for the production of standardized reagents to be used in the various laboratories throughout Canada which are interested in this field. The discovery of the Australia antigen marks the first breakthrough after many years of disappointing research in the field of laboratory diagnosis of viral hepatitis. This era has witnessed a rapid increase in the utilization of human whole blood and blood products for transfusion and a host of other purposes. The introduction of new and more sophisticated medical and surgical procedures, such as renal hemodialysis, exchange transfusion, organ transplantation, and open heart, cardiovascular and chest surgery, has multiplied the possibilities for introduction of bacterial and viral contamination into the blood stream of recipients. In short, it can be stated that whenever whole blood or certain blood products are transferred from one individual to another, the potential risk of transmitting hepatitis continues to exist, notwithstanding the vast amount of money spent on research trying to devise ways and means of obtaining protection against viral hepatitis. The detectability of the Australia antigen by relatively simple laboratory techniques constitutes a significant achievement which offers a new approach to solving problems related to blood transfusion procedures and ramifications thereof. The following program lists some of the priorities: