ABSTRACT
Thirty-four persistent healthy carriers of HBsAg (serum HBsAg detectable for longer than 3 months with normal liver function tests and normal liver histology or slight aspecific abnormalities) were discovered by routine testing of household relatives of B virus hepatitis patients. The carriers were followed-up for 11 to 37 months by clinical control, liver function tests and liver needle biopsy. None carrier had previous jaundice. During the follow-up period, in 17 of the 34 subjects, was there no evidence of deterioration in either clinical state, liver function of pathological findings. In 5 of the 34 carriers, HBsAg disappeared from serum after a period ranging from 6 to 12 months. The remaining 12 cases developed clinical and histological picture of acute viral hepatitis after 6 to 29 months (mean 12 months). Of these 12 patients, 6 recovered and become HBsAg; 2 remained HBsAg healthy carriers despite normalization of biochemical and histological abnormalities; 3 progressed from the acute stage to antigen positive CAH. The remaining one case could not be followed-up after the acute hepatitis. Our data indicate that the outcome of the HBsAg carrier state is unpredictable and stress the need of long-term follow-up surveillance.
Subject(s)
Carrier State , Hepatitis B Antigens/analysis , Adolescent , Adult , Age Factors , Child , Female , Follow-Up Studies , Humans , Italy , Liver Function Tests , Male , Population Surveillance , Sex FactorsABSTRACT
Two patients with fulminant hepatic necrosis and in stage IV coma were treated with a rapid infusion of refrigerated buffered albumin electrolyte solution combined with simultaneous total body wash-out in order to remove the circulating neurotoxins and to provide additional time for liver regeneration. Both patients awoke from the coma following treatment. One patient recovered completely, the other died on the second day as a result of massive gastro-intestinal bleeding. The clinical value and the technical problems of the procedure are investigated.
