Acute viral hepatitis A, B and non-A, non-B in Stockholm in the 1950s and 1970s: a comparison.

Abstract

The incidence of hepatitis types A (HA), B (HB) and Non-A, Non-B (NANB) and their epidemiology were studied in all patients admitted to the Roslagstull Hospital for acute viral hepatitis during five consecutive months in 1953–54 (Group I). This was before i. v. drug addiction had been encountered in Stockholm, Sweden. The results were compared with the findings in patients with acute viral hepatitis admitted during six consecutive months in 1970 (Group II) and during 13 consecutive months in 1977–78 (Group III) when i. v. drug addiction had become prevalent in Stockholm. Sera from all patients were tested for antibodies against hepatitis A virus (anti-HAV), for hepatitis B surface antigen (HBsAg) and the corresponding antibody (anti-HBs), and for antibody against hepatitis B core antigen (anti-HBc) using radioimmunoassay techniques (RIA) (HAVAB, AUSRIA II, AUSAB, and CORAB, Abbott Laboratories). HAVAB-positive sera were tested for anti-HAV-IgG and anti-HAV-IgM by a solid phase RIA. Hepatitis A was diagnosed in 31% (20/64), 28% (42/151), and 30% (84/277) in Groups I, II, and III, respectively. Hepatitis B was diagnosed in 55% (35/64), 62% (93/151) and 47% (129/277) in Groups I, II, and III, respectively. By excluding infections with HA and HB viruses, cytomegalovirus, and Epstein-Barr virus, NANB was diagnosed in 14% (9/64), 10% (15/151), and 23% (63/277) in Groups I, II, and III, respectively. HB dominated both before and after i. v. drug addiction had become prevalent. The relative number of HA cases was constant, irrespective of the year under investigation. NANB existed as early as the 1950s, and if i. v. drug addicts were excluded, the relative number of these infections was found to be constant, i. e. 14% and 14.8% in 1953–54 and 1977–78, respectively. I. v. drug addiction was found to have changed the epidemiological situation by decreasing the mean age of hepatitis patients, by increasing the male preponderance of HB and NANB patients, and by increasing the relative number of NANB cases.