De novo acute infection and reactivation of hepatitis B virus in established cirrhosis.
Five patients with cirrhosis proved by biopsy had clinical, biochemical, and serological evidence of an acute hepatitis B infection. In two the illness was fulminant and led to death. Only one patient completely recovered. Serological markers for the hepatitis B virus were absent before the onset of the acute illness in four patients, which suggested that a de novo infection had been acquired as a result of recent transfusions of blood or blood products. The fifth patient, who had Goodpasture's syndrome, had antibody to the core of hepatitis B virus, indicating previous exposure to the virus; his acute hepatitis may have been related to immunosuppressive drug treatment, which may have reactivated a dormant virus infection. Thus an acute type B viral hepatitis due to either a de novo or a reactivated infection may be superimposed on cirrhosis.
D000208:Acute Disease; D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000209:etiology*; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged