Infection with Delta Agent in Sweden: Introduction of a New Hepatitis Agent

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Abstract
To investigate the epidemiology of infection with delta (δ) agent in a Swedish city, 181 chronic carriers of hepatitis B surface antigen (HBsAg) and 599 patients with acute, self-limited hepatitis B were analyzed for δ antigen and antibody to δ antigen (anti-δ). The study covered the period from 1970 to 1981. The δ agent was found to have been introduced to this population in 1973. Markers of infection with δ agent were almost exclusively found in intravenous drug addicts and their close contacts. The proportion of drug addicts who were chronic HBsAg carriers with anti-δ increased with time and reached 72% in 1979–1981. An episode of acute hepatitis was frequently seen in connection with seroconversion to anti-δ. Among the domestic cases of acute, self-limited hepatitis, no simultaneous infections with hepatitis B virus and δ agent were found before 1975. From 1975 to 1980, between 18% and 44% of the drug addicts with acute hepatitis B were also infected with δ agent.