Sex differences in response to hepatitis B virus. III. Responses to HBV and sex of donor and recipient in kidney and bone marrow transplantation.

We proposed the hypothesis that there is an antigen on the hepatitis B virus (HBV) that cross-reacts with a male associated antigen to explain four observations: 1) sex differences in the responses to HBV infection, 2) sex differences in the prevalence of chronic liver diseases associated with hepatitis B, 3) the association of parental responses to HBV with the sex ratio (at birth) of their offspring, and 4) the relation of kidney graft survival with the combination of anti-HBs in the recipients and the sex of the organ donor. Patients with aplastic anemia treated with bone marrow transplantation from HLA identical sibling donors were studied to further test this hypothesis and the results provide additional support. Cross reactivity of HBsAg with H-Y antigen, however, has not been demonstrated.