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Delta Virus Infection and Severe Hepatitis: An Epidemic in the Yucpa Indians of Venezuela

STEPHEN C. HADLER, M.D.; MARIA DE MONZON, M.D.; ANTONIO PONZETTO, M.D.; ELIAS ANZOLA, M.D.; DALIA RIVERO, M.D.; ALEJANDRO MONDOLFI, M.D.; ANA BRACHO, M.D.; DONALD P. FRANCIS, M.D., D.Sc.; MICHAEL A. GERBER, M.D.; SWAN THUNG, M.D.; JOHN GERIN, Ph.D.; JAMES E. MAYNARD, M.D., Ph.D.; HANS POPPER, M.D., Ph.D.; and ROBERT H. PURCELL, M.D.
[+] Article and Author Information

▸Requests for reprints should be sent to Stephen C. Hadler, M.D.; Hepatitis Branch—Viral Diseases, Centers for Disease Control, 1600 Clifton Road, Building 6, Room 154; Atlanta, GA 30333.


Phoenix, Arizona; Maracaibo and Caracas, Venezuela; Rockville and Bethesda, Maryland; and New York, New York


Ann Intern Med. 1984;100(3):339-344. doi:10.7326/0003-4819-100-3-339
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Over a 3-year period, 149 Yucpa Indians in Venezuela developed hepatitis; 34 persons died and at least 22 developed chronic hepatitis. Children and young adults were primarily affected, especially males. Serologic testing showed that hepatitis B virus infection was highly endemic in this population, but also that 65% of patients had hepatitis B virus surface antigen (HBsAg) during or after illness. Most patients had evidence of delta-agent superinfection; 86% of HBsAg-positive patients had delta antibody, and delta antigen was found in specimens taken during autopsies on 7 of 9 patients. Serologic data suggested that most infections were due to delta superinfection of hepatitis B carriers, and that more than 60% of these infections progressed to chronic disease. Delta agent infection, and particularly delta superinfection of hepatitis B carriers, appears to be an ominous occurrence that may develop in populations among whom hepatitis B virus infection is endemic, and who have no other risk factor for delta infection.

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