title: An epidemic of hepatitis D in the foothills of the Himalayas in south Kashmir.
abstract: We have identified hepatitis D as an etiologic cause of an outbreak of 'hepatitis' in an endemic area for hepatitis B in South Kashmir, India. Thirty-five of the 51 patients with jaundice were hepatitis B virus carriers. Twenty-two of the 24 such patients tested had hepatitis D (hepatitis D virus superinfection). Two of the 3 patients with acute hepatitis B were coinfected with hepatitis D virus (HDV). Thirty-six asymptomatic household contacts of hepatitis D patients were assessed. Six were hepatitis B virus carriers, 3 of whom had HDV superinfection. Two contacts had acute hepatitis B, one with HDV coinfection. The disease occurred in adults with a mean age of 28.2 +/- 10.5 years (range 10-56 years) and was equally distributed between the sexes. Three patients with HDV superinfection presented with fulminant hepatic failure with a fatal outcome. All the patients with non-fulminant hepatitis D showed apparent clinical recovery. However, in the subsequent follow-up at 4 years, 7 patients with HDV superinfection had evidence of chronic hepatitis. One of these 7 patients died due to progressive chronic liver disease.
authors.affiliation: Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, India.
authors.forename: M S
authors.initials: MS
authors.lastname: Khuroo
authors.forename: S A
authors.initials: SA
authors.lastname: Zargar
authors.forename: R
authors.initials: R
authors.lastname: Mahajan
authors.forename: G
authors.initials: G
authors.lastname: Javid
authors.forename: R
authors.initials: R
authors.lastname: Lal
mesh_terms: D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000175:diagnosis; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006506:Hepatitis A / Q000175:diagnosis; D006509:Hepatitis B / Q000175:diagnosis; D003699:Hepatitis D / Q000453:epidemiology*; D006801:Humans; D007124:Immunoenzyme Techniques; D007194:India; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay