985 episodes of hepatitis representing 98% of all acute hepatitis episodes found in a Swedish city during a 10-year period were analyzed for anti-hepatitis A IgM antibodies and hepatitis B surface antigen. Hepatitis A was diagnosed in 311 episodes (32%), hepatitis B in 494 (50%), simultaneous acute hepatitis A and B in 12 (1.2%), and 168 episodes (17%) were classified as hepatitis non-A, non-B. The majority of the hepatitis A cases were drug addicts (58%), and all were concentrated in 3 outbreaks of 1-2 years duration. 16% of all hepatitis A cases were probably imported. Hepatitis B cases decreased significantly (p less than 0.001) between the first and second half of the study period. 47% were drug addicts. Hepatitis non-A, non-B was also dominated by drug addicts (61%). Approximately 20% of the cases in all 3 types of hepatitis had no identifiable source.
Serological analysis by radioimunoassay of sera from 297 patients hospitalized with acute non-toxic hepatitis was used for classification according to virus etiology. Radioimmunoassays included tests for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis A virus (anti-HAV), anti-HAV of IgM class, and antibody against cytomegalovirus (GMV) and Epstein-Barr virus. One patient with a significant rise in anti-CMV antibodies was classified as having CMV hepatitis. Among the 296 remaining patients serological markers indicated hepatitis A in 51 cases (17.2%) and hepatitis B in 208 cases (70.3%). The remaining 37 patients (12.5%) fulfilled criteria for acute non-A, non-B hepatitis. This type of hepatitis had symptoms and signs indistinguishable from those of hepatitis A, except for a slight tendency to milder disease on admission. A considerable proportion of patients with non-A, non-B hepatitis had a history of drug abuse (43.2%) and of recently traveling to endemic hepatitis areas (29.7%). In the remaining 27.1% no particular background was revealed. No case of post-transfusion hepatitis was seen. During the last 6 months of the study a striking change in epidemiology concerning hepatitis A was seen, apparently caused by a steep increase in the incidence of this type of hepatitis among drug addicts. No significant difference in biochemical liver tests was seen in non-a, non-B hepatitis or hepatitis A. In contrast, a marked and statistically significant difference in serum concentrations of IgM was found, with higher values (mean, 7.5 g/1; range, 3.2-13.9 g/1) in hepatitis A than in non-a, non-B hepatitis (mean, 3.3 g/1; range, 0.9-9.4 g/1). This difference may have diagnostic value.
[An epidemiological evaluation of the incidence of detecting markers of hepatitis B and C viral infection in the blood of the medical personnel of a large general hospital].
Virus hepatitis B and C are widespread human diseases of viral etiology, characterized by a common mechanism of the transmission of their etiological agents. The study of the routes of transmission of these infections in hospitals and the epidemiological characterization of the occurrence of the markers of hepatitis B and C among the medical personnel working in therapeutic and prophylactic institutions (TPI) are highly important problems. The data obtained in our investigations make it possible to determine the irregular character of the detection rate of the markers of virus infection among the medical personnel in different departments of a large hospital and to give explanation for such irregularity. A high morbidity rate in virus hepatitis B and C among the medical personnel continues to be one of serious problem facing TPI, and the improvement of the methods of their prevention is still a highly important task of hospital epidemiology.
Seamen constitute a special group of international travellers who may run an increased risk of contracting hepatitis, because of visits to foreign ports and the particular environment on board ship. The purpose of the survey was to assess the prevalence of serological markers for hepatitis A, B and C virus infection among seamen and to identify present and previous risk factors for infection. 515 seamen were studied. The prevalence of antibodies against hepatitis A was 0.3% in subjects below 40 years of age, increasing with age above 40 years, and highest among those who had sailed in international trade. The prevalence of antibodies against hepatitis B was 2.7% in subjects below 40 years of age, increasing to 35.7% in the group above 60 years of age. Hepatitis C antibodies occurred in 1.2%. Vaccination of sailors against hepatitis A should follow the same recommendations as to other travellers. The prevalence of hepatitis B was higher than in reference groups of non-seamen but, because hepatitis B is only one of many blood-borne diseases, prevention should be directed towards changes in behaviour rather than vaccination, except for special groups. Young seamen in international trade were found to be most at risk of contracting sexually transmitted diseases.
To examine the clinical and epidemiologic features of hepatitis C virus (HCV) infection in a gastroenterology/hepatology practice in Ottawa.
Retrospective chart review.
Sixty-three consecutive patients found to be anti-HCV positive. Their charts were analysed with respect to risk factors, history of hepatitis, serum aspartate aminotransferase (AST) levels and the presence of hepatitis B markers. The long-term sexual partners of 29 patients agreed to undergo HCV antibody testing.
Of the patients 48 (76%) had been exposed to HCV parenterally: 27 used intravenous drugs, and 21 had received blood or blood products. Eleven patients did not have any known risk factor (sporadic infection), but eight of them had lived in countries where hepatitis C may be more prevalent; the other three had locally acquired infection. The mean serum AST level at the first visit was 140 (normally less than 40) IU/L. At least one hepatitis B marker was identified in 33% of the patients. None of the sexual partners who were tested were anti-HCV positive.
Most cases of hepatitis C in Ottawa are acquired through parenteral exposure; sexual transmission is rare. Sporadic infection in the Ottawa region is rare but may be more common in people from countries with a higher prevalence rate of hepatitis C. Most cases of hepatitis C are asymptomatic.
A consecutive series of 115 patients hospitalized with acute viral hepatitis in Copenhagen was studied for serological markers for hepatitis A and B virus. Thirty-nine patients had type B, 66 had type A, 3 had both type A and B, and 7 had type non-A non-B. Of the patients 81% were between 15 and 40 years of age, and there was a dominance of males due to an overrepresentation of homosexual males (30%) in both the A and B group. The main type of exposure to hepatitis type A was travel to foreign countries (53%), and for type B it was drug addiction (41%). In types A and B the duration of jaundice was positively correlated to the age of the patients but did not vary with sex or type of exposure. There was no difference in maximum alanine aminotransferase levels between the groups, but maximum bilirubin levels were lower for the type A group. Patients with hepatitis type A had a higher level of IgM than those with type B and with type non-A and non-B. We conclude that both clinically acute hepatitis type A and type B occur mainly in young adults and that foreign travel, drug addiction, and homosexuality increase the risk of getting acute hepatitis.
