RESUMO
Fulminant hepatitis B virus (HBV) infection is often attributable to co-infection with the delta agent. However, delta produces a variable pattern of illness in HBsAg-positive addicts. It is often not detectable in fulminant cases of hepatitis B, and other cofactors have been conjectured regarding the pathogenesis of fulminant HBV disease. We present the case of an intravenous drug abuser with severe hepatitis B and concomitant infection with human immunodeficiency virus. We conclude that dual infection with these two viruses may be a factor in the development of fulminant hepatitis B in i.v. drug abusers, and might account for the atypical clinical course often observed.
Assuntos
Soropositividade para HIV , HIV/fisiologia , Hepatite B/microbiologia , Transtornos Relacionados ao Uso de Substâncias , Adulto , Feminino , Hepatite B/etiologia , Humanos , Injeções IntravenosasRESUMO
Physician assistants who provide care to inmates of the federal correctional system--and of prisons in general--face an array of challenges that their counterparts in other fields do not. The medical director of the nation's prison system describes those problems, offers an overview of the federal prison health care system, and provides a glimpse at the role of PAs in the system--including the rewards of practicing in a correctional facility.
