Hepatitis B The Virus, the Disease, and the Vaccine
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1 Hepatitis B The Virus, the Disease, and the Vaccine
2 Hepatitis B The Virus, the Disease, and the Vaccine Edited by Irving Millman Institute for Cancer Research Fox Chase Cancer Center Philadelphia, Pennsylvania Toby K. Eisenstein Temple University School of Medicine Philadelphia, Pennsylvania and Baruch S. Blumberg Institute for Cancer Research Fox Chase Cancer Center Philadelphia, Pennsylvania Springer Science+ Business Media, LLC
3 Main entry under title: Library of Congress Cataloging in Publication Data Hepatitis B: the virus, the disease, and the vaccine. "Proceedings of a symposium... held November 11-12, 1982, in Philadelphia, Pennsylvania" Verso t.p. Sponsored by Eastern Pennsylvania Branch, American Society for Microbiology and others. Includes bibliographical references and index. 1. Hepatitis B vaccine Congresses. 2. Hepatitis B Congresses. 3. Hepatitis viruses Congresses. I. Millman, Irving, II. Eisenstein, Toby K. III. Blumberg, Baruch S. IV. American Society for Microbiology. Eastern Pennsylvania Branch. QR189.5.H46H / ISBN ISBN DOI / ISBN (ebook) Proceedings of a Symposium on Hepatitis B: The Virus, the Disease, and the Vaccine, held November 11-12, 1982, in Philadelphia, Pennsylvania Springer Science+Business Media New York 1984 Originally published by Plenum Press, New York in 1984 Softcover reprint of the hardcover 1st edition 1984 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
4 SPONSORS OF THE THIRTEENTH ANNUAL CLINICAL MICROBIOLOGY SYMPOSIUM Eastern Pennsylvania Branch, American Society for Microbiology Merck Sharp & Dohme Bureau of Laboratories, Pennsylvania Department of Health Department of Microbiology and Immunology, Temple University School of Medicine Department of Microbiology and Immunology, Hahnemann University Department of Microbiology, Thomas Jefferson University Department of Microbiology, University of Pennsylvania School of Medicine Department of Microbiology, Medical College of Pennsylvania v
5 ORGANIZING COMMITTEE Conference Co-chairmen Baruch S. Blumberg Institute for Cancer Research Fox Chase Cancer Center Irving Millman Institute for Cancer Research Fox Chase Cancer Center Symposium Committee Chairperson Toby K. Eisenstein Temple University School of Medicine Committee Carl Abramson Pennsylvania College of Podiatric Medicine Josephine Bartola Bureau of Laboratories Pennsylvania Department of Health Lionville, PA Kenneth R. Cundy Temple University School of Medicine Morton Klein Temple University School of Medicine Linda Miller Bryn Mawr Hospital Bryn Mawr, PA Norman P. Willett Temple University School of Dentistry vi
6 ACKNOWLEDGMENTS The editors are indebted to the Eastern Pennsylvania Branch of the American Society for Microbiology under whose sponsorship this conference was held, and to the members of the organizing committee whose hard work made the symposium possible. We would also like to thank Dr. Henry Bielstein, the branch President for his encouragement and enthusiastic support of this endeavor. The Pennsylvania Department of Health-Bureau of Laboratories generously handled mailings and registrations. We are also grateful to Temple University School of Medicine, Hahnemann Medical College, Thomas Jefferson Medical College, and the School of Medicine of the University of Pennsylvania for their sponsorship. The Department of Microbiology and Immunology of Temple University and the Division of Clinical Research of the Institute for Cancer Research were particularly supportive of this conference and this volume by providing office services. This conference would not have been possible without the generous financial support of Merck Sharp and Dohme whose contribution we gratefully acknowledge. The excellent proofreading skills of Joyce Codispoti and Peggy Nowak are appreciated. Finally, many thanks to Maureen Walsh for her beautiful camera-ready copy of the manuscripts.
7 CONTENTS Introduction T. K. Eisenstein Keynote Address: The Australia Antigen Story. 5 B. S. Blumberg THE VIRUS AND ITS TRANSMISSION Hepatitis B Viruses J. Summers Medical Consequences of the Carrier State 45 W. T. London The Epidemiology of Hepatitis B 55 J. L. Dienstag CLINICAL AND DIAGNOSTIC PERSPECTIVES OF HBV The Morphologic Expression of Hepatitis B E. Skarinsky and E. Rubin 67 Assays for Hepatitis B Virus 95 C-M. Ling Immunologic Responses to Hepatitis B Virus and their Interpretations 105 B. G. Werner, J. L. Dienstag, B. J. Kuter, D. R. Snydman, B. F. Polk, D. E. Craven, R. Platt, C. S. Crumpacker, and G. F. Grady Hepatitis B Infection Control Among Physicians, Dentists and Laboratory Personnel 113 W. J. Schneider ix
8 x CONTENTS Control Measures for Hepatitis B Problems in Dentistry 123 V. J. Brightman and R. Weibel THE VACCINE The Development of the Hepatitis B Vaccine 137 I. Millman Clinical Experience with Hepatitis B Vaccine 149' A. A. McLean, E. B. Buynak, B. J. Kuter, M. R. Hi I 1eman, and D. J. West Hepatitis B Vaccine Trials, Experience and Review 161 R. E. Weibel Priorities for the Use of Hepatitis B Vaccine 175 R. H. Bernier, M. A. Kane, N. Nathanson, and D. P. Francis VACCINE ECONOMICS: ISSUES AND ANSWERS Newly Licensed Hepatitis B Vaccine R. J. Gerety 189 VACCINES OF THE FUTURE Characterization and Mapping of Viral and Putative Viral-Cellular Transcripts in a Hepatitis B Virus Infected Human Hepatoma Cell Line and in Chimpanzee Carrier Liver 195 P. R. Chakraborty, N. Ruiz-Opazo, and D. A. Shafritz Hepatitis B Surface Antigen Polypeptide and Synthetic Peptide Vaccines 215 G. R. Dreesman, I. Ionescu-Matiu, Y. Sanchez, R. C. Kennedy, J. T. Sparrow, and J. L. Melnick Synthesis and Assembly of Hepatitis B Virus Antigens in Heterologous Systems 225 P. Valenzuela, P. Bull, D. Coit, B. Craine, R. Hallewell, U. Heberlein, O. Laub, F. Masiarz, A. Medina, and S. Rosenberg Closing Remarks 237 I. Millman
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