Negative Serology for Hepatitis A and B Viruses in 18 Cases of Neonatal Cholestasis

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Abstract
Serologic evidence of hepatitis A virus (HAV) or hepatitis B virus (HBV) infection was sought in 14 patients with biliary atresia and in 4 patients with neonatal hepatitis; maternal serum was also analyzed. Specific sensitive radioimmunoassays were used to detect HBV surface antigen (HBsAg) and antibody (antiHBs); complement fixation was used to detect antibody to HBV core antigen (anti-HBc). Antibody to HAV (anti-HAV) was assayed by radioimmunoassay and by immune adherence hemagglutination. There was no evidence of active or past HBV infection in any infant or mother studied. All 3 infants with detectable anti-HAV were born to mothers similarly anti-HAV positive; serial testing of sera from 2 of these infants documented disappearance of detectable anti-HAV by 9 mo. of age. It is unlikely that either HAV or HBV had an etiologic role in neonatal cholestasis in these patients. The role of other (non-A, non-B) hepatitis viruses or nonviral etiologies must be investigated.

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