{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T22:08:50Z","timestamp":1791151730664,"version":"4.1.0"},"reference-count":9,"publisher":"BMJ","issue":"6359","license":[{"start":{"date-parts":[[1983,1,8]],"date-time":"1983-01-08T00:00:00Z","timestamp":410832000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,1,8]]},"abstract":"<jats:p>The clinical features of delta infection were analysed retrospectively in 191 hepatitis B surface antigen (HBsAg) carriers and 592 cases of acute hepatitis B seen over 11 years in the Swedish town of Malm\u00f6 (population 250 000). With a few exceptions delta infections occurred exclusively in drug addicts. In the chronic HBsAg-carriers the most common clinical manifestation was an episode of acute hepatitis, which in some individuals became severe with a pronounced rise in serum alanine aminotransferase activity for many months. During the period of delta infection the HBsAg titre was lowered and in three out of 26 cases the patient lost HBsAg altogether and developed hepatitis B surface antibodies (anti-HBs). In one patient the acute hepatitis due to delta infection was fulminant and fatal. In patients with acute hepatitis B the clinical picture did not distinguish between those with and without simultaneous delta infection. The frequency with which acute hepatitis B was succeeded by a chronic carrier state was the same whether or not the patient was infected simultaneously with the delta agent. The discovery of the delta agent has improved understanding of the natural history of chronic hepatitis B infection in drug addicts. Thus, instances of acute hepatitis in a chronic carrier, previously termed hepatitis non-A, non-B, may actually be episodes of delta infection.<\/jats:p>","DOI":"10.1136\/bmj.286.6359.87","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"87-90","source":"Crossref","is-referenced-by-count":84,"title":["Clinical aspects of delta infection."],"prefix":"10.1136","volume":"286","author":[{"given":"T","family":"Moestrup","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B G","family":"Hansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Widell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Nordenfelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1983,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/gut.18.12.997","article-title":"Immunofluorescence detection of a new antigen\/antibody system (delta\/anti-delta) associated with hepatitis B virus in liver and in serum of HBsAg carriers","volume":"18","author":"Rizzetto, M.; Canese, M.G.; Aric6, S.","year":"1977","unstructured":"Rizzetto M, Canese MG, Aric6 S, et al. Immunofluorescence detection of a new antigen\/antibody system (delta\/anti-delta) associated with hepatitis B virus in liver and in serum of HBsAg carriers. Gut 1977;18: 997-1003.","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/S0140-6736(80)91678-5","article-title":"Epidemiology of HBV-associated delta agent: geographical distribution of anti-delta and prevalence in polytransfused HBsAg carriers","volume":"i:","author":"Rizzetto, M.; Purcell, R.H.; Gerin, J.L.","year":"1980","unstructured":"Rizzetto M, Purcell RH, Gerin JL. Epidemiology of HBV-associated delta agent: geographical distribution of anti-delta and prevalence in polytransfused HBsAg carriers. Lancet 1980;i: 1215-9.","journal-title":"Lancet"},{"key":"ref_3","first-page":"590","article-title":"Transmission of the hepatitis B virus-associated delta antigen to chimpanzees. J7 Infect Dis","volume":"141","author":"Rizzetto, M.; Canese, M.G.; Gerin, J.L.; London, W.T.; Sly, D.L.; Purcell, R.H.","year":"1980","unstructured":"Rizzetto M, Canese MG, Gerin JL, London WT, Sly DL, Purcell RH. Transmission of the hepatitis B virus-associated delta antigen to chimpanzees. J7 Infect Dis 1980;141:590-602."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1093\/infdis\/146.4.472","article-title":"Delta-infection in Sweden: introduction of a new hepatitis agent","volume":"146","author":"Hansson, B.G.; Moestrup, T.; Widell, A.; Nordenfelt, E.","year":"1982","unstructured":"Hansson BG, Moestrup T, Widell A, Nordenfelt E. Delta-infection in Sweden: introduction of a new hepatitis agent. 7 Infect Dis 1982;146: 472-8.","journal-title":"7 Infect Dis"},{"key":"ref_5","first-page":"79","article-title":"IgM antibody to the hepatitis B core antigen in acute hepatitis determined by SPRIA-diagnostic value","volume":"90","author":"Widell, A.; Hansson, B.G.; Lofgren, B.","year":"1982","unstructured":"Widell A, Hansson BG, Lofgren B, et al. IgM antibody to the hepatitis B core antigen in acute hepatitis determined by SPRIA-diagnostic value. Acta Pathol microbiol Scand (B) 1982;90:79-82.","journal-title":"Acta Pathol microbiol Scand (B)"},{"key":"ref_6","first-page":"249","article-title":"Multicentre study of prevalence of HBV-associated delta infection and liver disease in drug addicts","volume":"i:","author":"Raimondo, C.; Smedile, A.; Gallo, L.; Balbo, A.; Ponzetto, A.; Rizzetto, M.","year":"1982","unstructured":"Raimondo C, Smedile A, Gallo L, Balbo A, Ponzetto A, Rizzetto M. Multicentre study of prevalence of HBV-associated delta infection and liver disease in drug addicts. Lancet 1982;i:249-53.","journal-title":"Lancet"},{"key":"ref_7","first-page":"992","volume-title":"the delta (8) agent in chronic HBsAg carriers. Gastroenterology 1981; 81","author":"Smedile, A.; Dentico, P.; Zanetti, A.","unstructured":"Smedile A, Dentico P, Zanetti A, et al. Infection with the delta (8) agent in chronic HBsAg carriers. Gastroenterology 1981;81:992-7."},{"key":"ref_8","article-title":"Accepted","year":"1982","unstructured":"(Accepted 9 September 1982)"},{"key":"ref_9","article-title":"In 1940 Burton and Taylor5 found that peripheral blood flow is subject to spontaneous flow oscillations that occur at frequencies of less than 01 Hz. Kitney' subsequently showed that by applying a certain range of periodic thermal stimuli to one hand the spontaneous variations in flow in the contralateral hand could be suppressed and replaced by strong oscillating variations occurring at the same frequency as the stimulus. This phenomenon is called entrainment and occurs when a stimulus is applied to an oscillating system at a frequency approaching its natural resonant frequency","unstructured":"In 1940 Burton and Taylor5 found that peripheral blood flow is subject to spontaneous flow oscillations that occur at frequencies of less than 01 Hz. Kitney' subsequently showed that by applying a certain range of periodic thermal stimuli to one hand the spontaneous variations in flow in the contralateral hand could be suppressed and replaced by strong oscillating variations occurring at the same frequency as the stimulus. This phenomenon is called entrainment and occurs when a stimulus is applied to an oscillating system at a frequency approaching its natural resonant frequency."}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.286.6359.87","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.286.6359.87","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T20:02:25Z","timestamp":1765310545000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.286.6359.87"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,1,8]]},"references-count":9,"journal-issue":{"issue":"6359","published-online":{"date-parts":[[1983,1,8]]},"published-print":{"date-parts":[[1983,1,8]]}},"alternative-id":["10.1136\/bmj.286.6359.87"],"URL":"https:\/\/doi.org\/10.1136\/bmj.286.6359.87","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1983,1,8]]}}}