LUDWIG A. LETTAU, M.D., M.P.H.; HOWARD J. ALFRED, M.D.; RICHARD H. GLEW, M.D.; HOWARD A. FIELDS, Ph.D.; MIRIAM J. ALTER, Ph.D.; RICHARD MEYER, M.D.; STEPHEN C. HADLER, M.D.; JAMES E. MAYNARD, M.D., Ph.D.
A previously asymptomatic carrier of hepatitis B virus receiving chronic hemodialysis developed acute delta hepatitis. The patient regularly received dialysis treatments on the same machine as a parenteral drug abuser with hepatitis B surface antigen (HBsAg)-positive chronic hepatitis whose serum was strongly positive for delta antibody. The drug abuser had a major bleeding episode that caused extensive environmental contamination 3 months before onset of illness in the index patient. No other patients receiving dialysis or staff members had evidence of delta infection. A surgeon previously infected with hepatitis B from the same parenteral drug abuser also had delta antibody. Testing for delta virus is indicated for both HBsAg-positive parenteral drug abusers and patients with hemophilia receiving chronic hemodialysis. All patients who are HBsAg- and delta-positive should receive dialysis separately from patients who are HBsAg-positive and delta-negative. Susceptible patients on dialysis and staff should receive hepatitis B vaccine to protect against both hepatitis B and delta virus infection.
LETTAU LA, ALFRED HJ, GLEW RH, FIELDS HA, ALTER MJ, MEYER R, et al. Nosocomial Transmission of Delta Hepatitis. Ann Intern Med. ;104:631–635. doi: 10.7326/0003-4819-104-5-631
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Published: Ann Intern Med. 1986;104(5):631-635.
Gastroenterology/Hepatology, Hospital-Acquired Infections, Infectious Disease, Liver Disease.
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