AUSTRALIA ANTIGEN: A REVIEW WITH EMPHASIS ON ITS CLINICAL RELEVANCE IN AUSTRALIA

The more recent developments in knowledge of the Australia antigen are reviewed, particularly those of clinical importance. The role of Au antigenaemia in acute and chronic hepatic disease, and in primary liver cell cancer, as well as its association with non‐hepatic disorders of the serum sickness type such as polyarteritis nodosa, arthritis, glomerulonephritis, and urticaria, is discussed. Although it is now accepted that the “carrier” state In blood donors is frequently associated with asymptomatic but nevertheless often serious liver disease, the natural history of the disease in these “carriers”, and therefore management, is less clear. Furthermore, the greater risk of infection with the serum hepatitis virus in laboratory and medical staff due to their exposure must be minimized. Current ideas on the pathogenesis of the disease are outlined, since they may influence principles of treatment, prognosis and prophylaxis. Finally, the uncertainty surrounding the possible development of chronic liver disease after attenuation by immunization has added a note of caution to immunization studies. Although disease associated with Australia antigen appears in general no different in Australia from that elsewhere, this country is fortunate in that it enjoys a lower incidence of antigenaemia and its associated diseases than that found in many other countries.