TY - JOUR
T1 - Natural history of acute hepatitis B surface antigen-positive hepatitis in Greek adults
AU - Tassopoulos, Nicolaos C.
AU - Papaevangelou, George J.
AU - Sjogren, Maria H.
AU - Roumeliotou-karayannis, Anastasia
AU - Gerin, John L.
AU - Purcell, Robert H.
N1 - Funding Information:
Received November 22, 1985. Accepted October 3, 1986. Address requests for reprints to: G. Papaevangelou, National Center for Viral Hepatitis, Athens School of Hygiene, Athens 11521,P .O. Box 14085,G reece. This study was supported in part by a grant from the Ministry of Health and Welfare and the Ministry of Research and Technology of Greece and NIAID contract No. NO1 AI 22665. Nicolaos C. Tassopoulos was a visiting scientist to the Fogarty International Center, National Institutes of Health, Bethesda, Maryland. The authors thank Ronald Engle for testing for hepatitis delta virus serologie markers, George Lagoudakis and Maria Kotsianopoulou for technical assistance, and Linda Jordan and Susan Harding for help in the preparation of the manuscript. 0 1987 by the American Gastroenterological Association 0018-5085/87/$3.50
PY - 1987/6
Y1 - 1987/6
N2 - We prospectively followed up 821 adults with acute viral hepatitis hospitalized at the Athens Hospital for Infectious Diseases between May 1981 and May 1983. Radioimmunoassays for the detection of serologic markers of hepatitis A virus, hepatitis B virus, and hepatitis δ virus, and molecular hybridization techniques for the detection of serum hepatitis B virus deoxyribonucleic acid and hepatitis δ virus ribonucleic acid were used. Based on the results of an enzyme immunoassay for the detection of immunoglobulin M antibody to hepatitis B core antigen (Corzyme-M), 563 cases were diagnosed as acute hepatitis B and 45 as acute hepatitis superimposed on hepatitis B surface antigen carriage. Development of the hepatitis B surface antigen carrier state was observed in only 1 (0.2%) of the 507 cases with acute hepatitis B that were followed. In contrast, hepatitis B surface antigen persisted in all the latter cases. Acute hepatitis superimposed on hepatitis B surface antigen carriage was attributed to (a) hepatitis A virus superinfection in 2 (4.4%), (b) hepatitis δ virus superinfection in 22 (48.9%), (c) reactivation of chronic type B hepatitis in 12 (26.7%), (d) seroconversion from hepatitis B e antigen-positive to anti-hepatitis B e antibody-positive in 2 (4.4%), (e) presumed superinfection by non-A, non-B agent(s) in 6 (13.4%), and (f) the first clinical manifestation of chronic active hepatitis in 1 (2.2%) case. These data show that (a) acute clinical hepatitis B in adults seems to be a self-limited disease and rarely leads to the development of the carrier state in this epidemiologic setting and (b) hepatitis δ virus superinfection and spontaneous reactivation of chronic hepatitis B are the principal causes of acute hepatitis superimposed in hepatitis B surface antigen carriers in an area with a moderately high prevalence of hepatitis B virus infections.
AB - We prospectively followed up 821 adults with acute viral hepatitis hospitalized at the Athens Hospital for Infectious Diseases between May 1981 and May 1983. Radioimmunoassays for the detection of serologic markers of hepatitis A virus, hepatitis B virus, and hepatitis δ virus, and molecular hybridization techniques for the detection of serum hepatitis B virus deoxyribonucleic acid and hepatitis δ virus ribonucleic acid were used. Based on the results of an enzyme immunoassay for the detection of immunoglobulin M antibody to hepatitis B core antigen (Corzyme-M), 563 cases were diagnosed as acute hepatitis B and 45 as acute hepatitis superimposed on hepatitis B surface antigen carriage. Development of the hepatitis B surface antigen carrier state was observed in only 1 (0.2%) of the 507 cases with acute hepatitis B that were followed. In contrast, hepatitis B surface antigen persisted in all the latter cases. Acute hepatitis superimposed on hepatitis B surface antigen carriage was attributed to (a) hepatitis A virus superinfection in 2 (4.4%), (b) hepatitis δ virus superinfection in 22 (48.9%), (c) reactivation of chronic type B hepatitis in 12 (26.7%), (d) seroconversion from hepatitis B e antigen-positive to anti-hepatitis B e antibody-positive in 2 (4.4%), (e) presumed superinfection by non-A, non-B agent(s) in 6 (13.4%), and (f) the first clinical manifestation of chronic active hepatitis in 1 (2.2%) case. These data show that (a) acute clinical hepatitis B in adults seems to be a self-limited disease and rarely leads to the development of the carrier state in this epidemiologic setting and (b) hepatitis δ virus superinfection and spontaneous reactivation of chronic hepatitis B are the principal causes of acute hepatitis superimposed in hepatitis B surface antigen carriers in an area with a moderately high prevalence of hepatitis B virus infections.
UR - http://www.scopus.com/inward/record.url?scp=0023212653&partnerID=8YFLogxK
U2 - 10.1016/0016-5085(87)90614-7
DO - 10.1016/0016-5085(87)90614-7
M3 - Article
C2 - 3569758
AN - SCOPUS:0023212653
SN - 0016-5085
VL - 92
SP - 1844
EP - 1850
JO - Gastroenterology
JF - Gastroenterology
IS - 6
ER -