Etiology of Fulminant Viral Hepatitis in Greece

Abstract

The etiology of fulminant viral hepatitis was determined in 65 consecutive cases among 1,814 (3.58%) adults with acute viral hepatitis who were admitted to the Infectious Diseases Hospital of Athens from May, 1981 to August, 1983. Radioimmunoassays were used to detect hepatitis B virus, hepatitis A virus and delta-agent markers. Enzyme immunoassay was used to detect anti-HBc IgM. Hepatitis B virus was responsible for 48 (73.9%), non-A, non-B for 16 (24.6%) and hepatitis A virus for one case (1.5%). The use of anti-HBc IgM identified 10 cases of fulminant type B hepatitis among HBsAg negative, anti-HBc and anti-HBs positive patients. Fulminant non-A, non-B hepatitis was superimposed on 10 asymptomatic HBsAg carriers; delta-agent co-infection was diagnosed in two fulminant type B hepatitis cases. These data show that hepatitis B virus is the major cause of fulminant hepatitis in Greece. HBsAg carriers are at high risk for fulminant non-A, non-B hepatitis. delta-agent does not seem to be as important as in Italy and other countries.

Severe acute exacerbation in chronic hepatitis B virus infection in Sendai, Japan.

“…Although a large number of patients with acute NANB hepatitis appear to be asymptomatic and anicteric (Dienstag 1983), those with advanced liver diseases may have a tendency to hepatic decompensation by superinfection of NANB hepatitis agent (s) like our cases (Papaevangelou et al 1984). Our failure to detect anti-HDV in the sera of patients experiencing severe exacerbation suggested that HDV infection may not play an important role in severe acute exacerbation in chronic carriers of HBsAg in Japan.…”

“…However, the exacerbations occasionally occur in hepatitis B surface antigen (HBsAg) carriers negative for HBeAg (Liaw et al 1987). Such exacerbations are considered to be induced by the spontaneous reactivation of chronic hepatitis B virus (HBV) infection and superinfections with hepatitis A virus (HAY) (Zachoval et al 1983;Davis et al 1984b), non-A, non-B (NANB) hepatitis agent (s) (Papaevangelou et al 1984) and hepatitis delta …”

“…However, the exacerbations occasionally occur in hepatitis B surface antigen (HBsAg) carriers negative for HBeAg (Liaw et al 1987). Such exacerbations are considered to be induced by the spontaneous reactivation of chronic hepatitis B virus (HBV) infection and superinfections with hepatitis A virus (HAY) (Zachoval et al 1983; Davis et al 1984b), non-A, non-B (NANB) hepatitis agent (s) (Papaevangelou et al 1984) and hepatitis delta virus (HDV) (Smedile et al 1982; Govindarajan et al 1984). Although patients suffer elevation of hepatic enzymes, the clinical symptoms are mild, or, like the physical findings of chronic liver diseases, often absent (Hoofnagle and Alter 1984).…”

The cost of hepatitis A infections in American adolescents and adults in 1997

“…This method provides an opportunity to obtain the collective judgement of those most familiar with the clinical and epidemiologic literature, and is required because studies of hepatitis A outcomes are often limited or conflicting. The first survey requested age-specific estimates of hepatitis A outcomes, with each item preceded by a summary of literature describing risks of hospitalization, 1,2,4,5,7,12 fulminant disease, [13][14][15] liver transplant, 16 and mortality. 1,2,17,18 Panelists also described treatment patterns for a typical patient with fulminant disease, using a structure similar to the case-series study.…”

Hepatitis virus non-A, non-B: The cause of a major public health problem in India

“…The serological markers for hepatitis virus B and hepatitis virus A were investigated using the following techniques: anti-hepatitis virus A (anti-HAV) IgM antibody was detected by enzyme-linked immunosorbent assay (ELISA) (4) or by radioimmunoassay using a HAVAB-M kit;a hepatitis B surface antigen (HBsAg) was detected by a micro-ELISA technique (5); and specific IgM antibody to hepatitis virus B core antigen (anti-HBc IgM) was detected in serum samples using a CORZYME-M kit. (8,9). Infection with the agent responsible for delta hepatitis has not been reported as significant in India.…”