Research Article

De novo acute infection and reactivation of hepatitis B virus in established cirrhosis.

Br Med J 1979; 2 doi: (Published 13 October 1979) Cite this as: Br Med J 1979;2:893
  1. A Theodossi,
  2. S P Wilkinson,
  3. B Portmann,
  4. Y White,
  5. A L Eddleston,
  6. R Williams,
  7. A J Zuckerman


    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.