Saracco G, Macagno S, Rosina F, Rizzetto M
Division of Gastroenterology, Ospedale Molinette: Turin, Italy.
Ann Intern Med. 1988 Mar;108(3):380-3. doi: 10.7326/0003-4819-108-3-380.
Of 377 cases of fulminant hepatitis in persons positive for hepatitis B surface antigen (HBsAg) in Greece, Italy, the United States, the United Kingdom, the Central African Republic, Taiwan, Egypt, and India, only 52% could be attributed to infection with hepatitis B virus, which was defined as the presence of the IgM antibody to the hepatitis B core antigen (IgM anti-HBc) and the absence of serum markers of infection by extraneous viruses. Thirty percent of cases were caused by coinfection with hepatitis B virus and hepatitis delta virus or by infection with hepatitis delta virus superimposed on carriers of chronic HBsAg. In 18.5% of the patients, the absence of IgM anti-HBc indicated that they were not known to carry HBsAg, but no obvious superimposed factor of hepatitis could be identified. The cause of fulminant hepatitis is complex, and major risk factors are a pre-existing HBsAg state and hepatitis delta virus infection. Superinfection of HBsAg carriers by non-A, non-B viruses seems to be the cause in a consistent proportion of cases.
在希腊、意大利、美国、英国、中非共和国、台湾地区、埃及和印度的377例乙型肝炎表面抗原（HBsAg）阳性的暴发性肝炎患者中，只有52%可归因于乙型肝炎病毒感染，乙型肝炎病毒感染的定义为存在乙型肝炎核心抗原IgM抗体（IgM抗-HBc）且无外来病毒感染的血清标志物。30%的病例是由乙型肝炎病毒和丁型肝炎病毒合并感染或慢性HBsAg携带者感染丁型肝炎病毒所致。在18.5%的患者中，未检测到IgM抗-HBc表明他们不携带HBsAg，但未发现明显的叠加性肝炎因素。暴发性肝炎的病因复杂，主要危险因素是既往存在的HBsAg状态和丁型肝炎病毒感染。HBsAg携带者被非甲非乙型病毒重叠感染似乎是一定比例病例的病因。
