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Fulminant Hepatitis A in Intravenous Drug Users with Chronic Liver Disease

Evangelos A. Akriviadis, MD; and Allan G. Redeker, MD
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Requests for Reprints: Evangelos A. Akriviadis, MD, USC Liver Unit, Building 500, Room 114, Rancho Los Amigos Medical Center, 7601 East Imperial Highway, Downey, CA 90242.

Current Author Addresses: Drs. Akriviadis and Redeker: USC Liver Unit, Rancho Los Amigos Medical Center, Downey, CA 90242.

Ann Intern Med. 1989;110(10):838-839. doi:10.7326/0003-4819-110-10-838
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This excerpt has been provided in the absence of an abstract.

Fulminant hepatitis is a rare complication of acute hepatitis A infection, with an estimated case fatality rate of 0.14% among hospitalized patients (1). Hepatitis A is transmitted primarily by the fecal-oral route (1). There has been an increased incidence of hepatitis A infection among intravenous drug users (2-5), and percutaneous transmission has been established in animals (6) and in humans (7-9). Whether mode of transmission and preexistent liver disease alter the usually benign course of hepatitis A infection is not known.

We report here four cases of fulminant hepatic failure associated with hepatitis A infection encountered in intravenous drug users


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