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March 14, 1980

Multiple Hepatitis Attacks in Drug Addicts

Author Affiliations

From the Department of Infectious Diseases (Drs Norkrans and Iwarson) and the Institute of Medical Microbiology, Department of Virology (Dr Hermodsson), University of Göteborg (Sweden); and the Max von Pettenkofer-Institut, University of Munich (Dr Frösner).

JAMA. 1980;243(10):1056-1058. doi:10.1001/jama.1980.03300360028019

. Radioimmunoassays for detection of hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), antibody to hepatitis A virus (anti-HAV), and anti-HAV of IgM class were used to verify hepatitis A and hepatitis B infection in 33 drug addicts with multiple attacks of hepatitis. Hepatitis A was confirmed serologically in 23 (32%) of 71 total hepatitis episodes, while hepatitis B was confirmed in 30 episodes (42%). The remaining 18 hepatitis episodes (25%) were, by serological exclusion, also of Epstein-Barr virus and cytomegalovirus infection, classified as hepatitis non-A, non-B. However, while as many as 13 (39%) of the 33 primary attacks of hepatitis were of the type non-A, non-B, this type was never observed as a third attack. In no case were two attacks of hepatitis A or hepatitis B demonstrated in the same individual, but two different episodes of hepatitis non-A, non-B were observed in one patient. The maximal serum levels of alanine aminotransferase and bilirubin were significantly lower in patients with hepatitis non-A, non-B as compared with those with hepatitis B. Development of chronic liver disease occurred in only two (7%) of the 28 addicts who continued to be followed up.

(JAMA 243:1056-1058, 1980)