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Thomas M. CosgriffDivision of Medicine Walter Reed Army Institute of Research, Washington, D.C. 20012

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29 February 1983

To the Editor

We are in agreement with the comments of Drs. Larouze and Dazza regarding screening of malaria inocula for hepatitis virus. While we mentioned in our article that we screened our inocula for hepatitis B antigen, it is our practice to test for anti-HBs and anti-HBc as well. In addition, we measure alanine and aspartate aminotransferase levels. When possible, we follow donors of malaria inocula (initial and rejuvenation) for a period of 6 months, combining blood testing and examination for detection of any evidence of hepatitis. We also make it a practice to use a single inoculum donor to infect multiple research subjects. These subjects, in turn, are followed for evidence of hepatitis.

These procedures give us a high degree of confidence that the malaria inocula used in our studies do not contain hepatitis B virus. While there is no serological marker for non-A, non-B hepatitis, measurement of aminotransferase levels, careful screening of inocula donors and recipients, and use of single donors for multiple volunteers reduces the risk of transmission of this type of hepatitis.