ABSTRACT
The delta virus (DV) was shown to be the predominant but not exclusive aetiology in 124 cases of fulminating hepatitis (FH) in the Central African Republic. The condition occurs in an endemo-epidemic form in young adults with no apparent risk factors. The mortality is high (88 p. 100) and the clinical features well established. After a short prodromic period, the patients develop severe jaundice, hepatic encephalopathy, and, in over 1/3 of cases, severe haemorrhage. Biologically, the main changes are related to hepatic cytolysis and insufficiency. Histology shows appearances of spongiocytic (steatosic) hepatitis in 81 p. 100 of cases. HBS antigen is found in 90 p. 100 of cases and DV markers are present in 53 p. 100 of these. The HBS Ag also occurs in 60 to 90 p. 100 of the close relatives of the patients and anti-DV antibodies occur in 40 to 90 p. 100 of these subjects. To the authors' knowledge, this is the first published series to demonstrate FH associated with DV in the African continent.
