Prevalence Of Hepatitis B Virus Markers Research Articles

Seroprevalence of hepatitis B and C in a Merseyside hospital for the mentally handicapped

This study reports the prevalence of antibodies to hepatitis B virus (HBV) and C virus (HCV), and the frequency of potential exposure to these viruses among patients and staff in six long-stay wards of a hospital caring for mentally handicapped adults from the Mersey region. A retrospective survey of risk behaviour among 134 patients and questionnaire survey of 75 nursing staff was performed. Serum samples from both groups were tested for HBV markers and patient sera for antibodies to HCV by enzyme-linked immunosorbent assay (ELISA). None of the 102 patients tested had antibodies against HCV, although 17 had detectable antibody to HBV core (anti-HBc). Seven out of the 17 were positive for HBV surface antigen. None was positive for IgM antibody to HBV core. Only 1 out of 61 staff had anti-HBc and none was positive for surface antigen. Twenty-nine of 75 (39%) staff reported bites sufficient to break the skin and 52 (69%) significant other injuries from patients; 25 (31%) of staff had not received HBV vaccination. None of the patients had received HBV vaccine. We conclude that HCV does not appear to be a major hazard in this closed community but the prevalence of HBV markers indicating past exposure among patients is high, vaccine uptake is incomplete and incidents which may allow viral transmission are frequent.

Hepatitis B virus infection in schistosomiasis mansoni

Schistosomiasis and hepatitis B virus (HBV) infection are very common in Brazil but the interrelationships between the two infections are poorly understood. We have undertaken a detailed serological study of the prevalence of HBV markers in 189 Brazilian patients with chronic schistosomiasis mansoni, 46 with hepatointestinal (HIS) and 143 with hepatosplenic (HSS) schistosomiasis, 12 of the latter having decompensated liver disease (HSSD), and in 50 control patients. Sera were tested for HBsAg, anti-e, anti-HBc, anti-HBs and HBV-DNA. Eighty-three (44%) of the 189 schistosoma patients had at least one marker of HBV infection, 18 of whom (10%) were seropositive for HBsAg. All the controls were HBsAg negative, but ten (20%) had anti-HBc and anti-HBs. There was no significant difference in the frequency of these markers between HIS (14/46, 30.4%), HSSC (43/131, 34.5%), and the controls. Among the HBsAg-positive patients, one had HIS (HBV-DNA negative), seven had HSSC (one HBV-DNA positive) and ten had HSSD (six HBV-DNA positive), a significant association of HBV carriage with HSSD (P << 0.001). Mean (+/- SD) ALT values were significantly (P < 0.001) higher in HBsAg-positive HSSD patients (70.7 +/- 18 IU/liter) than in those with HSSC (29.5 +/- 15 IU/liter). Liver biopsies were performed in 12 HBsAg-positive patients (one with HIS, three with HSSC, and eight with HSSD) and in 50 HBsAg-negative HSSC patients. Seven of the eight HSSD patients had chronic active hepatitis with cirrhosis, and one had inactive cirrhosis. All three patients with HSSC and the one with HIS had chronic persistent hepatitis, with periportal fibrosis in three.(ABSTRACT TRUNCATED AT 250 WORDS)

Seroepidemiology of hepatitis A and hepatitis B virus infection in a Gurkha community in Singapore.

The overall prevalence of hepatitis A virus (HAV) infection among the Gurkhas and their families stationed in Singapore was 83.2%, with antibody to HAV detected in 67 (38.1%) of 176 children under 5 years of age, 121 (76.6%) of 158 children between 5 and 14 years, and 600 (97.9%) of 613 older children and adults over age 15 years. Children born in Singapore (102/223 or 45.7%) had a significantly lower crude prevalence than those born in Nepal (85/110 or 77.3%) (P < 0.000001). The age-adjusted difference in prevalence was also statistically significant (P < 0.001). Susceptible children had a high risk of acquiring HAV infection when they travelled to Nepal. As for hepatitis B virus (HBV) infection, the prevalence of hepatitis B surface antigen (HBsAg) was 2.8%, with a higher rate in males (20/560 or 3.6%) than in females (6/384 or 1.6%). The highest HBsAg prevalence (4/26 or 15.4%) was in young adult Gurkhas 15-19 years of age. No significant difference in the crude prevalence of HBV markers was noted between children born in Singapore (45/224 or 20.1%) and those born in Nepal (19/107 or 17.8%). Even after age adjustment, the difference remained insignificant. The prevalence of HBV markers of children of seropositive parents (27/156 or 17.3%) was not significantly higher than that of seronegative parents (19/131 or 14.5%). Married men had a significantly higher age-adjusted prevalence of infection than unmarried men (45.4% and 32.4%, respectively; P < 0.05). Seropositivity of one spouse was significantly correlated with the seropositivity of the other (P < 0.05), suggesting a role for heterosexual transmission of HBV infection.

Prevalence of Hepatitis B Virus Markers among Intravenous Drug Abusers in Stockholm: Impact of Heterosexual Transmission

In order to study the importance of sexual transmission of hepatitis B virus (HBV) among intravenous drug abusers (IVDAs), and from IVDAs to others, we consecutively interviewed 171 IVDAs detained at the Stockholm Remand Prison during 4 months in 1990. Sexual histories revealed that 77% reported ≥3 sexual partners during the last 3 years, 64% had had a sexual partner who did not inject drugs, and 61% reported a prior STD. The prevalence of HBV markers was 75%. In a multiple logistic regression analysis, a high risk for HBV markers was associated with an increasing duration of drug abuse, a high prevalence of hepatitis A markers, and an increasing number of drug injecting sexual partners during the last 3 years, indicating that sexual transmission, along with sharing of needles, may contribute to the high prevalence of HBV markers within this group. It is suggested that an adequate sexual history must be obtained from IVDAs with acute viral hepatitis in order to identify sexual partners who should be offered postexposure prophylaxis, and that non-immune IVDAs should be vaccinated against viral hepatitis A and B.

Prevalence of Hepatitis B Virus Markers among Intravenous Drug Abusers in Stockholm: Impact of Heterosexual Transmission

In order to study the importance of sexual transmission of hepatitis B virus (HBV) among intravenous drug abusers (IVDAs), and from IVDAs to others, we consecutively interviewed 171 IVDAs detained at the Stockholm Remand Prison during 4 months in 1990. Sexual histories revealed that 77% reported > or = 3 sexual partners during the last 3 years, 64% had had a sexual partner who did not inject drugs, and 61% reported a prior STD. The prevalence of HBV markers was 75%. In a multiple logistic regression analysis, a high risk for HBV markers was associated with an increasing duration of drug abuse, a high prevalence of hepatitis A markers, and an increasing number of drug injecting sexual partners during the last 3 years, indicating that sexual transmission, along with sharing of needles, may contribute to the high prevalence of HBV markers within this group. It is suggested that an adequate sexual history must be obtained from IVDAs with acute viral hepatitis in order to identify sexual partners who should be offered postexposure prophylaxis, and that non-immune IVDAs should be vaccinated against viral hepatitis A and B.

Coincidence of Hepatitis B-Virus Markers and Other Sexually Transmitted Diseases in Different STD-Risk Groups

To evaluate the prevalence of hepatitis-B-virus (HBV)-markers in STD patients and the significance of promiscuous heterosexual activity as a risk factor for the transmission of HBV, a serological screening was performed in 499 patients, in addition to the routine STD diagnostic programme. Two groups of patients were evaluated: group 1 (120 patients) was drawn from the STD clinic of the Public Health Office (PHO), group 2 (379 patients) from a private STD outpatient clinic. Promiscuous activity was reported significantly more often by persons of group 1 than by those attending the private clinic (59.3% vs. 5.1%). The infection rate of gonorrhea, syphilis and Chlamydia trachomatis was high in patients of the PHO (46.7%, 35.3%, 27.5%) whereas most of the STDs were seldom ascertained in patients of the private clinic (1.1%, 0%, 5.6%). Similar to other STDs, the prevalence of HBV markers differed significantly between patients of the PHO and those of the private clinic (33.3% vs. 6.3%; p = .0000). Comparison of HBV and other STDs showed the highest coincidence of HBV markers in patients with serological evidence of syphilis (44.2%), and in one third of patients with Neisseria gonorrhoeae as well as HIV infection. The data obtained in the present study demonstrate that also in Austria, in addition to homosexual preference and drug abuse, promiscuous heterosexual activity must be considered a substantial risk factor for the transmission of HBV.

Prevalence of hepatitis B virus markers and exposure to occupational risks likely to be associated with acquisition of hepatitis B virus among health care workers in Stockholm

The prevalence of hepatitis B virus (HBV) markers and exposure to risks possibly associated with HBV transmission were investigated in 797 health care workers (HCW) from Stockholm. Altogether, 31/797 (3.9%) persons were positive for at least one HBV marker, 8.0, 7.9 and 6.4% respectively of children's nurses, laboratory assistants and psychiatric assistant nurses. A history of exposure to needle-stick injuries from any patient, was more often obtained from HCW with HBV markers than from HCW without such markers. The prevalence of HBV markers increased with age and duration of occupation in health care. Most HCW had been exposed to at least one occupational risk for HBV transmission early in their professional careers. Although the risk of acquiring HBV at present is low, the virus constitutes a potential occupational hazard for non-vaccinated HCW in Stockholm, a risk which may increase in the future since the number of chronic HBsAg carriers is increasing in Sweden.

Minor role of hepatitis B virus in the causation of chronic liver disease in Somalia indicated by a case-control study

Chronic liver disease (CLD) is frequent in Somalia. In a case-control study, 116 in-patients with CLD were compared with the same number of age and sex matched controls. Demographic variables, use of drugs, symptoms and signs, serological markers for hepatitis B virus (HBV) and serum α-foetoprotein (AFP) were assessed. Hepatitis B surface antigen (HBsAg) was found in 44 cases of which 17 had antibodies to hepatitis D virus (anti-HD) and 7 had hepatitis B e antigen (HBeAg). Twenty-three controls were HBsAg-positive, of whom 3 had anti-HD and one HBeAg. Increased relative risks (95% confidence intervals in parentheses) were 2·5 (1·3–4·5) for HBsAg, 6·5 (1·7–21·5) for anti-HD, and 7·4 (0·9–66·5) for HBeAg. Despite the association between the presence of HBV markers and CLD, 62% of the cases had no markers indicating current HBV infection. This was reflected in the low risk attributable to chronic HBV infection (22·6%), which was lower than that in patients with CLD in other African populations with a high HBsAg carrier rate. The prevalence of HBV markers did not differ between cases with AFP > 100 ng/ml and those with AFP < 100 ng/ml. The former were characterized by male predominance, shorter duration of symptoms, and larger mean liver size, indicative of malignancy. The mean age of HBsAg-positive cases with AFP > 100 ng/ml was significantly lower (by 7·7 years) than that of HBsAg-negative cases with AFP > 100 ng/ml. Among the CLD patients with AFP < 100 ng/ml, 48 were HBsAg-negative. These cases differed significantly from the other 68 cases in that more were females (35% against 16%), more originated from an agricultural area (56% against 30%), and more were regular consumers of drugs (48% against 28%). In conclusion, factors as yet undefined play a considerable role in the causation of CLD in Somalia. The possibility of determining the role of hepatitis C virus (HCV) awaits the development of more specific assays for anti-HCV antibodies.

Hepatitis B virus markers in Japanese immigrants and their descendants in Bolivia and native Bolivians

A survey of hepatitis B virus (HBV) markers of Japanese immigrants, their descendants and native Bolivians was performed in two agricultural settlements in Bolivia. The prevalence of HBV markers in sera, either hepatitis B surface antigen (HBsAg) or its antibody (HBsAb), was higher in the Japanese (46.4%) than in the native Bolivian (12.9%) adult generations of both colonies. There was no significant difference between Japanese (4.3%) and Bolivian (0.9%) school children in one colony, but a high percentage (32.6%) was recognized among Japanese children in the other colony. The numbers of adw subtypes were unexpectedly high among these HBsAg positive Japanese children, compared to those in Japan. Antibody to hepatitis delta virus (HDV) was detected in one case. These data suggested that although horizontal transmission of adw HBV had occurred within the Japanese population, HBV and HDV were not endemic to this geographic area.

A dynamic study of the intrafamilial spread of hepatitis b virus infection: Relation with the viral replication

A total of 848 household contacts of 285 hepatitis B surface antigen (HBsAg) chronic carriers were included in a prospective study. Of the total number of contacts negative for hepatitis B virus (HBV) markers at baseline, 330 relatives of 145 HBsAg carriers were observed over a mean period of 20.1 months. Among all household contacts, 284 (33.5%) were found positive for at least one HBV marker. The prevalence of HBV markers was significantly higher among the contacts of more than one HBsAg carrier (75.9%) than among those with only one (26.0%) (P less than .001). The presence of hepatitis B e antigen (HBeAg), specific HBV-DNA polymerase (HBV-DNAp), HBV-DNA, and polymerized human serum albumin (pHSA-R) in the index case was associated with a significantly higher incidence of HBV markers among household contacts. During the follow-up, the number of household contacts initially negative for HBV markers who became infected was found to be in direct relation to the presence of HBeAg, HBV-DNAp, HBV-DNA and pHSA-R in the index case.

The prevalence of hepatitis B serologic markers in suburban paramedics

Urban emergency medical services personnel have documented hepatitis B virus (HBV) seropositivity rates ranging from 0.6% to 25%. We studied 85 suburban paramedics for Hepatitis B serologic markers. All paramedics answered a questionnaire describing age, race, duration of employment, known hepatitis exposure, blood transfusions, gamma globulin injections, and Hepatitis B vaccination. HBV surface antibodies (Anti-HB,) were present in 6 85 (7.1%) paramedics of whom one (1.2%) had reactive HBV core antibodies (Anti-HB c). No paramedic had HBV surface antigen (HB sAg). Seropositivity was not associated with duration of employment, or exposure to a patient with either jaundice (28.2%) or confirmed hepatitis B (20.0%) within the six months prior to testing. The 7.1% prevalence of HBV markers found in this group of suburban paramedics is intermediate between previously reported rates for urban paramedics. We conclude that prehospital personnel do not constitute a homogenous occupational category at risk for hepatitis B infection.

HIV Infection in the Dominican Republic

To the Editor.— Koenig et al 1 recently described the epidemiology of human immunodeficiency virus (HIV) infection in the Dominican Republic. In that report, among the 1656 native Dominicans who were screened, 88 (5%) had HIV antibodies; however, of 259 Haitians residing in the Dominican Republic who were screened, 25 (10%) were seropositive. If 42 of the former group who were ill with acquired immunodeficiency syndrome (AIDS) or AIDS-related syndromes are excluded, the rate within healthy Dominicans drops to 3%. The Table describes further the distribution of HIV antibodies as well as the seroprevalence rate of hepatitis B virus (HBV) markers in both the Dominican Republic and Haiti (W. R. Lange, E. J. Cone, J. H. Jaffe, writtencommunication, March 1987). 1-5 The magnitude of disease penetration appears to be comparable in both countries, according to the overall prevalence of HBV markers (65%). However, in the presence of similar rates

Viral hepatitis among Danish oral surgeons

The aim of the study was to investigate the prevalence of previous clinical hepatitis B virus (HBV) infection and the prevalence of HBV markers in Danish oral surgeons, to estimate the annual HBV infection rate, and to assess whether the use of hepatitis B vaccine is to be recommended for this group. The total study population comprised 40 individuals occupied with oral surgery. A questionnaire and a request for a blood sample were sent to all dentists employed at the Danish hospitals and the departments of oral surgery at the 2 dental colleges. 36 (90%) answered a questionnaire, whereas only 27 (67.5%) had a blood sample taken for analysis of hepatitis surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis core antigen (anti-HBcAg), antibody to hepatitis A virus (anti-HAV), and serumtransaminases. One had been clinically ill from HBV infection and was positive for anti-HBs. The prevalence rate was thus 3.7% (95% confidence limits: 0.1%–19.0%) and the annual attack rate was 0.3%. The prevalence was not higher than among Danish dentists in general, and they are not considered a high-risk group in Denmark. Even with due statistical consideration to the present small sample, Danish oral surgeons do not seem to belong to a high-risk group like other surgeons in different medical specialities. It is concluded that the use of a hepatitis B vaccine is not recommended at present for this group of dentists.

Hepatitis B virus markers in diabetes mellitus.

Serum markers for hepatitis B virus (HBV) were studied in 395 healthy control subjects and in 100 diabetic patients. Of the patients, 28 had type I diabetes, 31 had type II diabetes requiring insulin, and 41 had type II diabetes treated with oral agents or diet alone. None gave history of previous icterus or other signs of hepatitis, had received blood transfusions, or had been on hemodialysis. There was a significant difference in the prevalence of HBV markers (mainly HB surface antibody) between the diabetic group and the controls (51% versus 25%, P less than 0.001). The control subjects included hospital personnel and, hence, their risk of HBV exposure was already relatively high. The increased occurrence of HBV markers did not seem to be related to diabetes duration, patient age, intake of insulin injections, or presence of microvascular complications. This study reveals a high degree of exposure to HBV in a moderately controlled diabetic group and possibly a high degree of proneness to subclinical hepatitis B.