[A rare etiology for HBs-Ag negative acute hepatitis B--coinfection by hepatitis B and delta].
An unusual case of a 25-year-old male Italian is reported. The patient endured an acute hepatitis without detectable HBs-antigen by coinfection with hepatitis-B and Delta. Coincidently, a cured hepatitis-C was present. Firstly hepatitis-B-virus DNA could be demonstrated in a small quantity by serodiagnosis (6 pg/ml, hybridization technique). Subsequently, the identification of B-virus DNA was only possible in liver tissue (PCR-technique), but no longer by serodiagnosis. The probable enduring inhibition of hepatitis-B-virus replication by Delta virus resulted in a self limitation of the disease within 2 months (HDV-RNA negative, HBs-Ag and HBe-Ag negative; Anti-HBs negative, Anti-HBe and Anti-HBc positive). In spite of negativation of replication markers for hepatitis-B a subsequent reactivation of the infection was possible by viral material which persisted in liver tissue.
Med. Klinik II, Städt. Klinikums Fulda.
T
T
Körner
D
D
Jaspersen
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J
Roth
C H
CH
Hammar
R
R
Bässler
D000208:Acute Disease; D000328:Adult; D006509:Hepatitis B / Q000175:diagnosis* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000276:immunology; D003699:Hepatitis D / Q000175:diagnosis* / Q000276:immunology; D003698:Hepatitis Delta Virus / Q000235:genetics; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods
D006514:Hepatitis B Surface Antigens
Seltene Ursache für eine HBs-Ag-negative akute Hepatitis B--die Koinfektion durch Hepatitis B und Delta.