The risks of transmission of the HTLV-III and hepatitis B virus in the hospital.

Abstract

In the hospital, both HTLV-III and hepatitis B virus are most likely to spread via infected blood or contaminated blood products. A summary of the main factors affecting spread of these viruses and some observations made at the author's hospital in central London, will be discussed here.AIDS was first recognized in Britain in 1981 and up to August 1985 there were 206 confirmed cases of AIDS with 114 deaths. The majority of patients with AIDS have been male homosexuals and less than 15% of the cases occurred outside of London. By August 1985 over 10,000 cases of AIDS had been reported in the US and it is clear by comparison that the current epidemic in Britain is in its early stages. Only a minority of London homosexuals have been infected. It is possible that an aggressive public health campaign could slow the course of the epidemic. Measures needed would include an increase in education, publicity, facilities for HTLV-III antibody tests, trained social workers and counseling on a massive scale. In the meantime the number of hospitalized patients with known HTLV-III infections has increased considerably during the last 2 years in certain hospitals in London (Figure 1). Approximately 33% of homosexuals attending sexually transmitted diseases (STD) clinics in London have serological evidence of HTLV-III infection. A few hospitals in central London have seen most of the patients with known HTLV-III or hepatitis B infections mainly because of the concentrations of homosexuals, drug addicts or other “risk groups” in the local catchment areas of these hospitals. A small number of hospitals in London and elsewhere in Britain have special hemophiliac centers and currently these centers have generally noted that more than 50% of their hemophiliac patients already have serological evidence of HTLV-III infection. Recent reports have documented the rate of increase of HTLV-III infections in British hemophiliac patients. During the last few years in London less than 10% of male homosexuals known to have HTLV-III infection and less than 1% of infected hemophiliac patients have developed AIDS.