Epidemic hepatitis with delta-antigenaemia among dublin drug-abusers

Hepatitis D

“…Additional investigation may reveal a higher incidence in subgroups such as parenteral drug users. The clinical features of acute hepatitis D are virtually indistinguishable from acute hepatitis B [8][9][10]13]. In some patients with simultaneous infection, biphasic hepatitis oc curs, with a second elevation of bilirubin and hepatic enzymes corresponding to the hepati tis D [10].…”

“…Whether simultaneous infection with HBV and HDV increases the risk of fulminant hepatitis has not been resolved. In Sweden and in Ireland, investigators concluded that simultaneous infection was no different in outcome than acute hepatitis B alone [8,9]. However, ful minant hepatitis B was very uncommon, sug gesting the possibility of other factors de creasing the incidence of fulminant disease.…”

“…Acute hepatitis with the presence of both HBV and HDV has been reported from many different areas [8][9][10][11][12][13][14][15] (table II). In some countries, HDV infection appears to be restricted to the population of parenteral drug users and their contacts [8][9][10][11]. Longitudinal investigation of the epide miology of HDV infection may demonstrate spread to other groups.…”

Etiology and Clinical Pattern of Fulminant Hepatitis in Iraq

“…This discrepancy may be explained by the varying degree of endemicity of the delta virus. Countries with high endemicity would have a greater subclinical infection than those countries where the virus has recently been introduced [10,11].…”

Hepatitis D

“…Delta antigen, if present in serum, has been associated with active delta infection in either chronic HBsAg carriers or in cases of simultaneous acute infection with HBV and delta agent. The report of acute hepatitis with delta antigenemia in one HBsAg negative patient with pre-existing anti-HBs is of interest [28]. The presence of anti-HBs without concurrent HBsAg may in some circumstances be associated with po tential HBV replication [30].…”