title: Nosocomial transmission of delta hepatitis.
abstract: A previously asymptomatic carrier of hepatitis B virus receiving chronic hemodialysis developed acute delta hepatitis. The patient regularly received dialysis treatments on the same machine as a parenteral drug abuser with hepatitis B surface antigen (HBsAg)-positive chronic hepatitis whose serum was strongly positive for delta antibody. The drug abuser had a major bleeding episode that caused extensive environmental contamination 3 months before onset of illness in the index patient. No other patients receiving dialysis or staff members had evidence of delta infection. A surgeon previously infected with hepatitis B from the same parenteral drug abuser also had delta antibody. Testing for delta virus is indicated for both HBsAg-positive parenteral drug abusers and patients with hemophilia receiving chronic hemodialysis. All patients who are HBsAg- and delta-positive should receive dialysis separately from patients who are HBsAg-positive and delta-negative. Susceptible patients on dialysis and staff should receive hepatitis B vaccine to protect against both hepatitis B and delta virus infection.
mesh_terms: D000328:Adult; D002353:Carrier State; D003428:Cross Infection / Q000635:transmission*; D006436:Hemodialysis Units, Hospital; D006508:Hepatitis Antibodies / Q000032:analysis; D006509:Hepatitis B / Q000150:complications / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000032:analysis; D006511:Hepatitis B Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D003699:Hepatitis D / Q000635:transmission*; D035923:Hepatitis delta Antigens; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000635:transmission; D010564:Personnel, Hospital; D006435:Renal Dialysis / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000276:immunology
chemical_list: D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D006514:Hepatitis B Surface Antigens; D035923:Hepatitis delta Antigens