title: The etiology of acute hepatitis superimposed upon previously unrecognized asymptomatic HBsAg carriers.
abstract: To study the etiology of acute hepatitis superimposed upon previously unrecognized asymptomatic HBsAg carriers, paired sera were collected in acute and convalescence phases for measurement of HBeAg, anti-HBe, hepatitis B virus DNA and anti-delta from 76 adult patients with acute hepatitis who were HBsAg positive but IgM anti-HBc negative or positive only at low titer. None of them were IgM anti-hepatitis A virus positive on admission. Of the 34 patients who were HBeAg positive initially, two (5.9%) were diagnosed as having delta superinfection, and another two (5.9%) were suspected to have non-A, non-B virus superinfection because of a transient decrease of serum hepatitis B virus DNA. The remaining 30 (88.2%) cases were hepatitis B virus DNA negative with or without anti-HBe seroconversion on follow-up. The episodes of acute hepatitis in these cases may represent "immune clearance of HBeAg" or "immune clearance of hepatitis B virus with delayed anti-HBe seroconversion," respectively, in the natural course of chronic hepatitis B virus infection. Of the patients who were anti-HBe positive initially, 23 (54.8%) were diagnosed as having delta superinfection, including eight with de novo seroconversion of anti-delta and 15 with a rising titer of anti-delta; 10 (23.8%) were positive for hepatitis B virus DNA and were considered as reactivation of hepatitis B virus, and the other nine (21.4%) were suspected as having non-A, non-B virus superinfection.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Liver Unit, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
authors.forename: C M
authors.initials: CM
authors.lastname: Chu
authors.forename: Y F
authors.initials: YF
authors.lastname: Liaw
authors.forename: C C
authors.initials: CC
authors.lastname: Pao
authors.forename: M J
authors.initials: MJ
authors.lastname: Huang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002353:Carrier State; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006505:Hepatitis / Q000209:etiology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D006526:Hepatitis C / Q000276:immunology; D003699:Hepatitis D / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens