{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:14:51Z","timestamp":1760865291575,"version":"3.37.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":9680,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1989,3]]},"abstract":"\n \n To study the etiology of acute hepatitis superimposed upon previously unrecognized asymptomatic HBsAg carriers, paired sera were collected in acute and convalescence phases for measurement of HBeAg, anti-HBe, hepatitis B virus DNA and anti-delta from 76 adult patients with acute hepatitis who were HBsAg positive but IgM anti-HBc negative or positive only at low titer. None of them were IgM anti-hepatitis A virus positive on admission. Of the 34 patients who were HBeAg positive initially, two (5.9%) were diagnosed as having delta superinfection, and another two (5.9%) were suspected to have non-A, non-B virus superinfection because of a transient decrease of serum hepatitis B virus DNA. The remaining 30 (88.2%) cases were hepatitis B virus DNA negative with or without anti-HBe seroconversion on follow-up. The episodes of acute hepatitis in these cases may represent \u201cimmune clearance of HBeAg\u201d or \u201cimmune clearance of hepatitis B virus with delayed anti-HBe seroconversion,\u201d respectively, in the natural course of chronic hepatitis B virus infection. Of the patients who were anti-HBe positive initially, 23 (54.8%) were diagnosed as having delta superinfection, including eight with de novo<\/jats:italic> seroconversion of anti-delta and 15 with a rising titer of anti-delta; 10 (23.8%) were positive for hepatitis B virus DNA and were considered as reactivation of hepatitis B virus, and the other nine (21.4%) were suspected as having non-A, non-B virus superinfection. We conclude that the vast majority of episodes of acute hepatitis in HBeAg carriers may represent immune clearance of hepatitis B virus in the natural history of chronic hepatitis B virus infection, and, by contrast, in anti-HBe carriers they are usually the result of superinfection with other non-B viruses, the majority of which are due to delta superinfection.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/hep.1840090319","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T22:56:32Z","timestamp":1172962592000},"page":"452-456","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":48,"title":["The etiology of acute hepatitis superimposed upon previously unrecognized asymptomatic HBsAg carriers"],"prefix":"10.1097","volume":"9","author":[{"given":"Chia-Ming","family":"Chu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Fan","family":"Liaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia 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