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Fulminant Hepatitis in Asymptomatic Hepatitis B Surface Antigen Carriers in Greece

✍ Scribed by Nicolaos C. Tassopoulos; George J. Papaevangelou; Anastasia Roumeliotou-Karayannis; John R. Ticehurst; Stephen M. Feinstone; Robert H. Purcell; Antonina Smedile; Ronald Engle

Publisher: John Wiley and Sons
Year: 1986
Tongue: English
Weight: 565 KB
Volume: 20
Category: Article
ISSN: 0146-6615
DOI: 10.1002/jmv.1890200410

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✦ Synopsis

Eleven male fulminant hepatitis (FH) patients (mean age: 47.7 +/- 16 years) positive for hepatitis B surface antigen (HBsAg) but negative for IgM antibody to hepatitis B core antigen (IgM anti-HBc) were admitted consecutively to the Athens Hospital for Infectious Diseases between May 1981 and November 1983. Because of the absence of IgM anti-HBc, determined by an enzyme immunoassay, these patients were considered to be HBsAg carriers with a superimposed acute hepatitis. Three of the 11 patients received immunosuppressive chemotherapy during the six months before the onset of the acute hepatitis. None of the patients was homosexual or a drug addict. Infection with hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis delta virus (HDV) was detected with serologic markers and/or molecular hybridization techniques. Fulminant hepatitis was attributed to spontaneous reactivation of chronic hepatitis B in four patients, chemotherapy-induced reactivation of chronic hepatitis B in three patients, HDV superinfection in one patient and possible superinfection by non-A, non-B agent(s), HDV, or HDV-like agents in three patients. Reactivation of chronic hepatitis B was an important cause of apparent acute hepatitis in heterosexual male HBsAg carriers from an area with a high prevalence of HBV infection.

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