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7 January 1983
To the Editor:
In their interesting article entitled “Evaluation of the antimalarial activity of the phenanthrenemethanol halofantrine (WR 171,669)” (Am. J. Trop. Med. Hyg., 31: 1075–1079, 1982), Cosgriff et al. induced malaria by intravenous injection of parasitized red blood cells obtained from previously infected volunteers. They stated that “All malaria inocula were evaluated for the hepatitis B antigen and were found to be negative.”
However, in experiments such as these, screening for HBsAg might not be sufficient. Indeed, it is well established that the hepatitis B virus (HBV) can be transmitted by blood which is negative for HBsAg. In particular, transfusion studies have shown that blood which is negative for both HBsAg and anti-HBs but positive for anti-HBc might be implicated. Therefore, to reduce this risk further, it might be worth testing the HBsAg-negative inocula, or the HBsAg-negative volunteers from whom the inocula are obtained, for anti-HBc. If anti-HBc is present, anti-HBs should be assayed.