Ronald C. Hershow, MD; Bruno B. Chomel, DVM; Donald R. Graham, MD; Paul M. Schyve, MD; Eric J. Mandel, MS; Mark A. Kane, MD; Howard A. Fields, PhD; Stephen C. Hadler, MD
Objective: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population.
Design: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays.
Setting: Thirteen Illinois state facilities for the developmentally disabled.
Participants: Clients (238) who were hepatitis B carriers.
Results: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30%) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85% of positive persons had lived there compared with 16% of negative controls (odds ratio 28.3 [95% CI, 13.2 to 60.7], P < 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37% compared with 7%) (odds ratio, 7.5 [95% CI, 3.0 to 19.1], P < 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients.
Conclusions: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti-HDV-positive clients may be explained by increased mortality among those originally infected from 1950 to 1975.
Learn more about subscription options.
Register Now for a free account.
Hershow RC, Chomel BB, Graham DR, Schyve PM, Mandel EJ, Kane MA, et al. Hepatitis D Virus Infection in Illinois State Facilities for the Developmental Disabled: Epidemiology and Clinical Manifestations. Ann Intern Med. 1989;110:779-785. doi: 10.7326/0003-4819-110-10-779
Download citation file:
Published: Ann Intern Med. 1989;110(10):779-785.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only