Abstract
Sera from three socioeconomically distinct, age-stratified, patient populations were tested for antibody to hepatitis B antigen (anti-HBAg) by a sensitive radioimmunoassay procedure. Patients who were drug users or had overt liver disease were excluded from the sample. The populations studied were: admissions to Harlem Hospital, a municipal hospital serving a low socioeconomic status Black population; admissions to Staten Island Hospital, a voluntary hospital, serving a middle socioeconomic class White population; and consecutive patients of high socioeconomic status seen in a Park Avenue internist's practice. A population of former drug addicts was also studied. The frequency of anti-HBAg was, in general, directly related to the age and inversely related to the socioeconomic status of the individuals studied. Little antibody was acquired before 20 years of age; between 20 and 50 years there was a striking rise, with no increase thereafter. By the age of 50, antibody was present in 43% of patients from Harlem, in 22% of patients from Staten Island, and 15% of the Park Avenue patients. Antibody was found in 52% of former drug addicts. Exposure to HBAg seemed to be widespread in the Harlem population, less so on Staten Island, and even less so in affluent predominantly White patients. The antibody-acquisition curve differed from that of most fæcal/ orally transmitted viral diseases. These findings suggest that the virus of hepatitis B is endemic in low socioeconomic populations and that it is probably spread, in part, by non-parenteral (or inapparent parenteral) means.
Published Version
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