VIRAL HEPATITIS: MULTIPLE ATTACKS IN A NARCOTIC ADDICT

Abstract

Three apparently self-limited episodes of jaundice occurred at intervals of 1 year in a narcotic addict who had been receiving intravenous injections in group practice of narcotic administration once a week for 3 years. Although it is impossible to define accurately factors that potentiated 3 attacks of hepatitis, the following lines of speculation are valid in view of the relatively solid immunity usually associated with infection with hepatitis virus A and the poorly defined immune response following infection with hepatitis virus B. If one attack of hepatitis was caused by virus A, the other 2 might have been caused by: (a) a strain of virus B that evoked insufficient antibody to prevent reinfection or (b) im-munologically different strains of virus B. If, however, virus A was not operative, all 3 attacks might have been caused by a strain or strains of virus B. The possibility must also be considered that this patient might be a carrier of hepatitis virus B in the blood and, under certain circumstances, equilibration between host and virus might be so disturbed as to result in repeated attacks of clinical disease.