Patterns of shedding of hepatitis A virus antigen in feces and of antibody responses in patients with naturally acquired type A hepatitis.

Serial stools and sera from 13 patients with hepatitis A were collected during an epidemic in 1978 in a rural village near Hangzhou, China, and were studied to determine the patterns of shedding of hepatitis A antigen (HAAg) and of antibody response in some cases. Of 44 stool specimens, 31 were HAAg-positive by a radioimmunoprecipitation-polyethylene glycol assay. The highest percentage of HAAg positivity was in stools collected one week before and one week after the peak elevation of serum glutamic pyruvic transaminase (SGPT) levels, and peak HAAg shedding in each patient usually occurred in the early stools. Fecal shedding of HAAg was detected as early as day 19 before peak elevation in SGPT level and as late as day 11 afterward and continued for at least 25 days. The pattern of HAAg shedding in feces and of complement-fixation and immune adherence antibody response in relation to the change in SGPT activity and jaundice in four patients with hepatitis A was demonstrated.