Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations

R. C. Hershow, Bruno B Chomel, D. R. Graham, P. M. Schyve, E. J. Mandel, M. A. Kane, H. A. Fields, S. C. Hadler

Research output: Contribution to journalArticle

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Abstract

Objective: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population. Design: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays. Setting: Thirteen Illinois state facilities for the developmentally disables. Participants: Clients (238) who were hepatitis B carriers. Results: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30%) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85% of positive persons had lived there compared with 16% of negative controls (odds ratio 28.3 [95% CI, 13.2 to 60.7], P < 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37% compared with 7%) (odds ratio, 7.5 [95% CI, 3.0 to 19.1], P < 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients. Conclusions: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti-HDV-positive clients may be explained by increased mortality among originally infected from 1950 to 1975.

Original languageEnglish (US)
Pages (from-to)779-785
Number of pages7
JournalAnnals of Internal Medicine
Volume110
Issue number10
StatePublished - 1989
Externally publishedYes

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Hepatitis Delta Virus
Virus Diseases
Epidemiology
Hepatitis B
Antibodies
Odds Ratio
Liver Function Tests
Hepatitis
Population
Case-Control Studies
Liver Diseases
Chronic Disease
Demography
Mortality
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hershow, R. C., Chomel, B. B., Graham, D. R., Schyve, P. M., Mandel, E. J., Kane, M. A., ... Hadler, S. C. (1989). Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations. Annals of Internal Medicine, 110(10), 779-785.

Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations. / Hershow, R. C.; Chomel, Bruno B; Graham, D. R.; Schyve, P. M.; Mandel, E. J.; Kane, M. A.; Fields, H. A.; Hadler, S. C.

In: Annals of Internal Medicine, Vol. 110, No. 10, 1989, p. 779-785.

Research output: Contribution to journalArticle

Hershow, RC, Chomel, BB, Graham, DR, Schyve, PM, Mandel, EJ, Kane, MA, Fields, HA & Hadler, SC 1989, 'Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations', Annals of Internal Medicine, vol. 110, no. 10, pp. 779-785.
Hershow, R. C. ; Chomel, Bruno B ; Graham, D. R. ; Schyve, P. M. ; Mandel, E. J. ; Kane, M. A. ; Fields, H. A. ; Hadler, S. C. / Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations. In: Annals of Internal Medicine. 1989 ; Vol. 110, No. 10. pp. 779-785.
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abstract = "Objective: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population. Design: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays. Setting: Thirteen Illinois state facilities for the developmentally disables. Participants: Clients (238) who were hepatitis B carriers. Results: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30{\%}) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85{\%} of positive persons had lived there compared with 16{\%} of negative controls (odds ratio 28.3 [95{\%} CI, 13.2 to 60.7], P < 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37{\%} compared with 7{\%}) (odds ratio, 7.5 [95{\%} CI, 3.0 to 19.1], P < 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients. Conclusions: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti-HDV-positive clients may be explained by increased mortality among originally infected from 1950 to 1975.",
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AU - Hershow, R. C.

AU - Chomel, Bruno B

AU - Graham, D. R.

AU - Schyve, P. M.

AU - Mandel, E. J.

AU - Kane, M. A.

AU - Fields, H. A.

AU - Hadler, S. C.

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N2 - Objective: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population. Design: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays. Setting: Thirteen Illinois state facilities for the developmentally disables. Participants: Clients (238) who were hepatitis B carriers. Results: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30%) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85% of positive persons had lived there compared with 16% of negative controls (odds ratio 28.3 [95% CI, 13.2 to 60.7], P < 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37% compared with 7%) (odds ratio, 7.5 [95% CI, 3.0 to 19.1], P < 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients. Conclusions: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti-HDV-positive clients may be explained by increased mortality among originally infected from 1950 to 1975.

AB - Objective: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population. Design: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays. Setting: Thirteen Illinois state facilities for the developmentally disables. Participants: Clients (238) who were hepatitis B carriers. Results: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30%) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85% of positive persons had lived there compared with 16% of negative controls (odds ratio 28.3 [95% CI, 13.2 to 60.7], P < 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37% compared with 7%) (odds ratio, 7.5 [95% CI, 3.0 to 19.1], P < 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients. Conclusions: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti-HDV-positive clients may be explained by increased mortality among originally infected from 1950 to 1975.

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