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.
LUDWIG A. LETTAU, HOWARD J. ALFRED, RICHARD H. GLEW, HOWARD A. FIELDS, MIRIAM J. ALTER, RICHARD MEYER, et al. Nosocomial Transmission of Delta Hepatitis. Ann Intern Med. 1986;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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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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