Abstract
To assess the epidemiological and pathogenic effects of infection with the hepatitis-B-virus (HBV)-associated delta (δ) agent in addicts who take drugs parenterally, 225 symptomless addicts from Italy and 261 addicts with HBsAg-positive hepatitis from Italy, Denmark, Switzerland, and Ireland were tested for δ antigen (δ-Ag) and its antibody (anti-δ) by radioimmunoassay. 79 liver biopsy specimens from HBsAg-positive addicts were also tested for intrahepatic δ-Ag by immunofluorescence. Anti-δ was found in 9 (27%) of 33 of the symptomless HBsAg-positive addicts, in 13 (8%) of 156 of those without HBsAg but with anti-HBs, and in none of those negative for HBV markers. The prevalence of serum δ-Ag or anti-δ among addicts with HBsAg-positive hepatitis was 64% (104/161) in Italy, 44% (8/18) in Denmark, 33% (11/33) in Switzerland, and 31% (15/49) in Ireland. 32 of the 79 (40%) liver biopsy specimens from HBsAg-positive addicts showed positive δ-Ag immunofluorescence. δ infection occurring simultaneously with HBV infection is common and possibly a major cause of liver disease in drug addicts who receive drugs parenterally. The spread of δ infection in drug-using communities is not confined to one country, and the drug habit may represent the major means by which δ agent spreads in areas of the Western world where this infection is not endemic.
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