Theodossi A, Wilkinson S P, Portmann B, White Y, Eddleston A L, Williams R, Zuckerman A J
Br Med J. 1979 Oct 13;2(6195):893-5. doi: 10.1136/bmj.2.6195.893.
Five patients with cirrhosis proved by biopsy had clinical, biochemical, and serological evidence of an acute hepatitis B infection. In two the illness was fulminant and led to death. Only one patient completely recovered. Serological markers for the hepatitis B virus were absent before the onset of the acute illness in four patients, which suggested that a de novo infection had been acquired as a result of recent transfusions of blood or blood products. The fifth patient, who had Goodpasture's syndrome, had antibody to the core of hepatitis B virus, indicating previous exposure to the virus; his acute hepatitis may have been related to immunosuppressive drug treatment, which may have reactivated a dormant virus infection. Thus an acute type B viral hepatitis due to either a de novo or a reactivated infection may be superimposed on cirrhosis.
经活检证实为肝硬化的5例患者有急性乙型肝炎感染的临床、生化及血清学证据。其中2例病情呈暴发性，导致死亡。仅1例患者完全康复。4例患者在急性病发作前无乙型肝炎病毒血清学标志物，这提示因近期输血或血液制品而获得了一次新感染。第5例患有古德帕斯丘综合征的患者有乙型肝炎病毒核心抗体，表明既往接触过该病毒；他的急性肝炎可能与免疫抑制药物治疗有关，这种治疗可能使潜伏的病毒感染重新激活。因此，无论是新发感染还是再激活感染所致的急性B型病毒性肝炎都可能叠加于肝硬化之上。
