Infection with Delta Agent in Sweden: Introduction of a New Hepatitis Agent

Abstract

To investigate the epidemiology of infection with delta (delta) agent in a Swedish city, 181 chronic carriers of hepatitis B surface antigen (HBsAg) and 599 patients with acute, self-limited hepatitis B were analyzed for delta antigen and antibody to delta antigen (anti-delta). The study covered the period from 1970 to 1981. The delta agent was found to have been introduced to this population in 1973. Markers of infection with delta agent were almost exclusively found in intravenous drug addicts and their close contacts. The proportion of drug addicts who were chronic HBsAg carriers with anti-delta increased with time and reached 72% in 1979-1981. An episode of acute hepatitis was frequently seen in connection with seroconversion to anti-delta. Among the domestic cases of acute, self-limited hepatitis, no simultaneous infections with hepatitis B virus and delta agent were found before 1975. From 1975 to 1980, between 18% and 44% of the drug addicts with acute hepatitis B were also infected with delta agent.

Delta hepatitis: molecular biology and clinical and epidemiological features

“…The prevalence of HDV infection is low among Southeast Asian refugee immigrants and essentially absent among high-risk populations, including North American and Canadian Eskimos and other Asian refugees (129). 18 and 44% of intravenous drug users with acute hepatitis B were also infected with HDV (92). A similar outbreak occurred among parenteral drug users in Worcester, Mass., from 1983 through 1985.…”

Etiology and Clinical Pattern of Fulminant Hepatitis in Iraq

“…This discrepancy may be explained by the varying degree of endemicity of the delta virus. Countries with high endemicity would have a greater subclinical infection than those countries where the virus has recently been introduced [10,11].…”

Hepatitis D

“…Acute hepatitis with the presence of both HBV and HDV has been reported from many different areas [8][9][10][11][12][13][14][15] (table II). In some countries, HDV infection appears to be restricted to the population of parenteral drug users and their contacts [8][9][10][11]. Longitudinal investigation of the epide miology of HDV infection may demonstrate spread to other groups.…”

“…In Italy, the overall inci dence of delta agent infection was 14% of 687 HBsAg positive acute hepatitis cases [12], There was marked geographic and epidemio logic variability with the presence of delta agent infection varying from 0.1-91% [12]. In Sweden, a retrospective study of HBsAg positive acute hepatitis has been carried out [9,10]. Of 592 cases of acute hepatitis occur ring between 1970 and 1981, 57 had evi dence of delta agent infection.…”