Caporaso N, del Vecchio-Blanco C, Servillo F, Suozzo R, Pignalosa G, Manzillo G, Maio G, Izzo C M, Coltorti M
Gastroenterol Clin Biol. 1984 Aug-Sep;8(8-9):646-50.
A previous study of 159 consecutive cases of HBsAg+ acute viral hepatitis, observed from the onset of disease and seen between May 1977 and May 1980, revealed a higher frequency of evolution to chronicity in the region of Naples than that reported for other areas. This suggested that environmental factors might influence the chronically rate. We investigated 125 HBsAg+ acute hepatitis cases for whom sera were available: 35 patients who remained HBsAg+ at the two-year control (28 chronic hepatitis and 7 healthy carriers) and 90 who recovered and seroconverted HBsAg---- anti-HBs during follow-up. At the onset of disease, all patients who cleared HBsAg showed IgM anti-HBc positivity and 48 were also HBeAg positive; no patient was anti-delta positive. On the contrary of the 28 chronic cases only 7 were IgM anti-HBc+ (6 under 13 years old), while 21 were IgM anti-HBc- but anti-delta+. This study demonstrates that not all HBsAg+ acute hepatitis cases are due to HBV and that in our area, superinfection by the delta agent is responsible for most cases of chronic HBsAg positive hepatitis.
一项对1977年5月至1980年5月期间从疾病发作开始观察的159例连续性HBsAg阳性急性病毒性肝炎病例的先前研究显示，那不勒斯地区慢性化演变的频率高于其他地区报道的频率。这表明环境因素可能影响慢性化率。我们调查了125例有血清可用的HBsAg阳性急性肝炎病例：35例在两年对照时仍为HBsAg阳性（28例为慢性肝炎，7例为健康携带者），90例在随访期间康复并发生HBsAg血清转换——抗-HBs阳性。在疾病发作时，所有清除HBsAg的患者均显示IgM抗-HBc阳性，48例同时HBeAg阳性；无患者抗-HDV阳性。与28例慢性病例相反，仅7例IgM抗-HBc阳性（6例年龄在13岁以下），而21例IgM抗-HBc阴性但抗-HDV阳性。这项研究表明，并非所有HBsAg阳性急性肝炎病例都由HBV引起，在我们地区，丁型肝炎病毒重叠感染是大多数慢性HBsAg阳性肝炎病例的原因。
