DELTA HEPATITIS IN INAPPARENT CARRIERS OF HEPATITIS-B SURFACE-ANTIGEN - A DISEASE SIMULATING ACUTE HEPATITIS-B PROGRESSIVE TO CHRONICITY

  • 1 January 1983
    • journal article
    • research article
    • Vol. 85  (3) , 669-673
Abstract
Infection with the hepatitis B surface antigen (HBsAg)-associated delta agent (.delta.) was determined in a series of Italian patients with a diagnosis of acute hepatitis B (HbsAg-positive) progressive to chronicity. A total of 22 of 27 (81%) and 12 of 18 (67%) patients collected, respectively, in Naples and Cagliari [Italy], where .delta. is highly endemic, developed IgM antibody to .delta. and/or rising titers of IgG anti-.delta. during the initital acute phase of the disease. In each of them, anti-.delta. increased to a high-titered plateau indicative of chronic .delta. infection. Delta markers were found in none of the 13 patients collected in Siena, where the prevalence of .delta. infection is low. The great majority of the patients with anti-.delta. and a progressive form of HBsAg-positive hepatitis lacked the IgM antibody to hepatitis B core antigen. They were presumably unrecognized carriers of HBsAg who became infected by .delta. and developed hepatitis induced by this agent. In areas where .delta. is endemic, it may represent the true cause of seemingly type B hepatitis progressing to chronic HBsAg-positive liver disease.

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