RESUMO
A patient admitted to a general medical ward for evaluation of jaundice was transferred to an intensive care unit when he developed a hemorrhagic diathesis and hepatic encephalopathy. Fifteen days elapsed before it was recognized that the patient was infected with hepatitis B virus (HBV), during which time the staff took no precautions other than routine hand washing. On subsequent evaluation of risk, it was decided that administration of an immunoglobulin preparation was not indicated despite the patient's massive contamination of his immediate environment. Of 89 persons heavily, casually, or indirectly exposed, none developed clinical illness within six months following contact. A nurse, first tested 30 days after contact, was persistently hepatitis B surface antigen-positive, but results of testing for antibody to core antigen demonstrated she was a long-term carrier. Among 61 susceptible staff members tested serially, none had serologic evidence of HBV infection. Thus, not all HBV-infected patients are highly contagious. Nonetheless, procedures to prevent such unprotected exposures are needed.
Assuntos
Infecção Hospitalar , Hepatite B/transmissão , Idoso , Animais , Vetores de Doenças , Feminino , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B/isolamento & purificação , Vírus da Hepatite B/imunologia , Humanos , Icterícia/etiologia , Masculino , Recursos Humanos em HospitalAssuntos
Adenocarcinoma/diagnóstico por imagem , Sulfato de Bário , Neoplasias do Colo/diagnóstico por imagem , Endoscopia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Biópsia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Humanos , RadiografiaRESUMO
SH virus-associated antigens have been identified in the liver and blood by immunofluorescence. This antigenic expression of the hepatitis agent or its genome is found in the cytoplasm of hepatocytes and other cells of the liver. Acute hepatitis is associated with hepatocellular localization of SH antigen, whereas alternative or additional SH antigen in the cytoplasm of nonhepatocytes is observed in chronic or recurrent hepatitis. Persistent intrahepatic SH antigen has also been observed in conversion from acute to chronic hepatitis, and the persistence of this virus-associated antigen in the liver may serve a significant pathogenetic role in mediating direct anti-tissue responses as well as local immune complex reactions. Competitive inhibition studies of SH antigen suggest at least two antigenically and sterically independent determinants on the SH particle.
