INFEZIONE CRONICA DA HBV: RUOLO DI ALTRI VIRUS. NOTA 2

On the basis that HBV is not cytopathic, we investigated if patients with chronic HBV infection, experiencing an acute transient icteric hepatitis, could have been superinfected by other viruses, or if nonviral causes may have played a role in their clinical outcome. HBs, 'e' system and anti-HBc were researched by RIA (Abbott), anti-HBc IgM and delta agent by ELISA, anti-VCA IgM EBV by I.F., in 59 HBs positive patients clustered in groups A and B. A = 22 patients with acute icteric episodes. Of these, 1 (4%) was shown to be EBV, 6 (28%) delta and 11 (50%) NANB superinfections (60% of the delta and NANB were DA of professional/household contacts). Non viral factors were likely the cause of the icteric episode (with fatal outcome in 3) in 4: one alcoholic cirrhotic, one immuno-compromised host, two recipients of kidney graft in treatment with cyclophosphamide. B = 37 symptomless subjects. In 12 (32%) we detected delta agent. Conclusions: 80% of the transient acute hepatitis among chronic HBs patients were due to other viruses (NANB, delta, EBV), whereas in 20% non-viral causes were implicated (with a high fatal outcome). All the same, delta agent was detected in nearly one-third of the asymptomatic chronic HBs carriers.