KEVIN M. DE COCK, M.D., M.R.C.P., D.T.M.&H.; DANIEL W. BRADLEY, Ph.D.; NEVILLE L. SANDFORD, M.B.B.S., B.Sc.Med., F.R.A.C.P.; SUGANTHA GOVINDARAJAN, M.D.; JAMES E. MAYNARD, M.D., Ph.D.; ALLAN G. REDEKER, M.D.
Epidemic non-A, non-B hepatitis was diagnosed in three young Pakistani men during a 10-month period at the Los Angeles County-University of Southern California Medical Center. All three patients had recently visited or lived in Karachi, Pakistan. None had serologic markers of hepatitis B virus infection or IgM antibody (acute-phase) to hepatitis A virus. A liver biopsy from one patient showed marked cholestasis and cholangiolar transformation of hepatocytes, a pattern previously described in patients with epidemic non-A, non-B hepatitis. Immune electron microscopy of a stool specimen obtained from this patient 10 days after the onset of symptoms showed virus-like particles, 27 nm in diameter, that were specifically aggregated by antibody contained in acute-phase sera from the three Pakistani patients, from patients with non-A, non-B hepatitis in Burma and Nepal, and from an experimentally infected marmoset. Recognition of three separate cases of probable epidemic-type non-A, non-B hepatitis in patients at one institution during such a short time suggests that Pakistan is endemic for this infection and that the disease may be more commonly spread to the United States than is now presumed.
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DE COCK KM, BRADLEY DW, SANDFORD NL, GOVINDARAJAN S, MAYNARD JE, REDEKER AG. Epidemic Non-A, Non-B Hepatitis in Patients from Pakistan. Ann Intern Med. 1987;106:227–230. doi: 10.7326/0003-4819-106-2-227
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Published: Ann Intern Med. 1987;106(2):227-230.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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