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.; ROBERT H. PURCELL, M.D.
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.
HADLER SC, DE MONZON M, PONZETTO A, ANZOLA E, RIVERO D, MONDOLFI A, et al. Delta Virus Infection and Severe Hepatitis: An Epidemic in the Yucpa Indians of Venezuela. Ann Intern Med. ;100:339–344. doi: 10.7326/0003-4819-100-3-339
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Published: Ann Intern Med. 1984;100(3):339-344.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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