Fatal hepatitis B reactivation after autologous bone marrow transplantation.

We report a fatal case of hepatitis B reactivation following autologous bone marrow transplantation for acute lymphocytic leukaemia. The presence of antibodies to HBs and HBc at presentation indicated previous infection with hepatitis B; these antibodies disappeared during the course of treatment for leukaemia. HBsAg was first detected in serum 5 weeks post-transplant; liver function tests began to deteriorate 8 weeks later, when HBeAg was first detected. The hepatitis followed a fulminant course, and the patient died 10 days later, in the 15th week following transplant.

A follow-up study of hepatitis B virus carriers at hospital.

For the purpose of clarifying the relation between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC), a follow-up study of 1,614 HBV carriers (910 males and 704 females) was conducted at Kure National Hospital from 1970 to 1984. During the follow-up period (40.3 months on average), 247 HBV carriers died. Deaths from HCC and liver cirrhosis (LC) numbered 99 of 168 males (58.9%) and 38 of 79 females (48.2%), the chi-square test revealing no sex difference. Of 142 deaths from malignant neoplasm, HCC accounted for 52 of 96 males (54.2%) and 19 of 46 females (41.3%), the chi-square test again revealing no sex difference. The adjusted odds ratio of death from HCC among HBV carriers (1,614) with respect to HBV non-carriers (176,909) in this hospital during the study period (14-years) was 9.52 (males 7.94, females 13.39). The expected number of deaths was calculated based on the population of Hiroshima Prefecture (1978-1980) as a standard. The adjusted O/E (observed number/expected number) ratio of death from HCC was 6.66 for males and 12.13 for females, and the adjusted O/E ratio of death from LC was 5.41 for males and 11.02 for females. These findings suggest that HBV is a high risk factor of both HCC and LC, and, unlike the general population, female HBV carriers may have a rather higher risk of death from HCC and LC than male HBV carriers.

Iron-binding proteins, hepatitis B virus, and mortality in the Solomon Islands.

The hypothesis that serum levels of ferritin and transferrin are associated with subsequent mortality was tested in a population of Solomon Islanders who had been followed over an 8-12-year period beginning in 1966. A case-control analysis of 105 matched pairs showed that 1966-1970 levels of ferritin were higher and levels of transferrin were lower in Solomon Islanders who had died by 1978 than in matched controls who were alive in 1978. These findings support the hypothesis and, in addition, are consistent with the view that increased iron stores are associated with increased mortality. Among females, the association of ferritin with mortality was more pronounced in chronic carriers of hepatitis B virus than in noncarriers.