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Familial clustering of hepatitis B Antigen and liver diseases in families with a high incidence of viral hepatitis

Familiäre Anhäufung von Hepatitis-B-Antigen und Leberkrankheiten in Familien mit häufigem Vorkommen von Virushepatitis

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Summary

In each of 23 families in which two or more cases of acute hepatitis-like jaundice (index cases) occurred, all family members were studied to evaluate HBAg clustering and the incidence of asymptomatic liver disease. There were 49 “index cases” of hepatitis-like jaundice: 38 cases of acute viral hepatitis, 5 of chronic agressive hepatitis and 6 of active cirrhosis. The overall number of members in these families (excluding index cases) was 170 and 155 of which were tested by clinical examination, laboratory tests and needle liver biopsy. In 27 out of the 155 subjects there was evidence of liver diseases (10 non icteric hepatitis cases, 12 CAH cases and 5 cirrhosis cases). HBAg was present in the serum of 19 of these patients, and two of the cirrhotic patients were positive. Furthermore, 33 of the 155 cases were healthy HBAg carriers showing no abnormality in liver function tests. In the majority of these carriers liver histology showed slight damage (pin-head necrosis or portitis) sometimes compatible with resolving viral hepatitis. A long-term follow-up of the HBAg carriers showed that three of these subjects progressed to acute viral hepatitis.

Zusammenfassung

In jeder der 23 Familien mit zwei- oder mehrfachem Auftreten von hepatitisförmiger Gelbsucht (Indexfälle) wurden alle Familienmitglieder untersucht, um die HBAg-Anhäufung und das Vorkommen asymptomatischer Leberkrankheiten zu beurteilen. Die „Indexfälle“ von hepatitisförmiger Gelbsucht beliefen sich auf 49; ferner 38 Fälle von akuter Virushepatitis, 5 Fälle von chronisch aggressiver Hepatitis und 6 Fälle von akuter Zirrhose. Die Gesamtzahl der Mitglieder in diesen Familien (ausschließlich der Indexfälle) betrug 170, wovon 155 durch klinische Untersuchung, Labortests und bioptische Leberpunktion geprüft wurden. Bei 27 der 155 Personen fand sich der Nachweis von Leberkrankheiten (10 Fälle von antikterischer Hepatitis, 12 Fälle von chronisch aggressiver Hepatitis und 5 Fälle von Zirrhose). Bei 19 dieser Patienten war HBAg im Serum vorhanden, zwei der zirrhotischen Patienten waren positiv. Ferner waren 33 der 155 Fälle gesunde HBAg-Träger ohne Anomalie der Leberfunktionstests. Bei der Mehrzahl dieser Träger ergab der histologische Leberbefund eine leichte Schädigung (nadelkopfförmige Nekrose oder Portitis), die manchmal einer wiederauflösenden Virushepatitis entsprach. Eine longitudinale Nachbeobachtung der HBAg-Träger zeigte, daß drei dieser Personen akute Virushepatitis entwickelten.

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Authors and Affiliations

  1. Clinic of Infectious Diseases, First Medical School, University of Naples, Via D. Cotugno 1 (Ospedale Gesù e Maria), 80135, Naples, Italy

    F. Piccinino &  E. Sagnelli

  2. D. Cotugno Hospital for Infectious Diseases, Fourth Division, 80132, Naples, Italy

    G. Manzillo,  G. Balestrieri &  G. Maio

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  1. F. Piccinino
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  2. G. Manzillo
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The following abbreviations are used HBAg=Hepatitis B Antigen; AIVH=Acute Icteric Viral Hepatitis; ANVH=Acute Nonicteric Viral Hepatitis; CAH=Chronic Aggressive Hepatitis; CIRRH.=Cirrhosis; GOT=Glutamic-Oxaloacetic Transaminase; GPT=Glutamic-Pyruvic Transaminase.

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Piccinino, F., Manzillo, G., Sagnelli, E. et al. Familial clustering of hepatitis B Antigen and liver diseases in families with a high incidence of viral hepatitis. Infection 3, 99–104 (1975). https://doi.org/10.1007/BF01641050

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