Epidemiology of Serum Hepatitis

Incidences of antibodies to hepatitis B, herpes simplex and cytomegalovirus in prostitutes

The 170 prostitutes registered by the local public health authority (165 female, 5 male; ages 17-61) were serologically investigated by ELISA and CFT for the presence of hepatitis B virus (HBV) markers (n = 170), anti-CMV (n = 118) and anti-HSV 2 antibodies (n = 117). 4.7% (1.2%) were found to be HBs- (HBe-)antigen carriers; 1.2% revealed an acute hepatitis B (seroconversion of anti-HBc or IgM-anti-HBc highly positive); 17.1% presented a past and resolved hepatitis B (anti-HBs positive). These rates exceeded those of 125 female age-matched control persons considerably, out of whom only 2.4% (0.8%) presented HBs-(HBe-) antigen and 3.2% anti-HBs antibodies. 90% of the prostitutes investigated proved to be anti-CMV IgG (1.7% IgM) antibody positive and were compared to healthy blood donors (47% IgG, 0% IgM-anti-CMV antibody carriers) and other CMV risk groups: pregnant women 56 (13), patients in hemodialysis 61 (0), hemophiliac patients 69 (0), patients after kidney transplantation 90 (16) and after open-heart surgery 87 (4) % anti-CMV IgG (IgM) antibody carriers. An AIDS patient suffered from simultaneous HBV and CMV infections. The risk of HSV 2 infection is among prostitutes (38.5% seropositives) five times as high as among female age-matched control persons (7.2% seropositives, n = 125). These results confirm that prostitutes must be regarded as a risk for the spread of hepatitis BV and CMV- and HSV 2-caused diseases in the population.

[The characterization of clinically healthy hepatitis-b-surface-antigen (HBsAg)-carriers. Clinical, biochemical, histiological and immunological investigations in 129 case of a prospective study (author's transl)]

129 blood donors found to be HBsAg-positive on routine testing were studied for evidence of hepatic disease. Twelve had already lost the antigen from the serum when histologically examined. None of these has had clinical or histological evidence of inflammatory liver disease. Two of the 129 patients showed mild icteric hepatitis, cleared the antigen during the follow up and became anti-HBs positive. The remaining 115 patients who appeared clinically healthy and who had no history of previous icteric liver disease remained HBsAg positive during a mean follow up period of 17.3 +/- 3.0 months. Forty patients from these had a normal liver histology and 37 mild to distinct steatosis but no signs of inflammatory liver disease. 11 patients a mild nonspecific mesenchymal activity but no focal necrosis, 16 patients had mild infiltration in portal tracts and a few necrotic parenchymal cells with mesenchymal reaction, 6 patients had chronic persistent hepatitis, 4 chronic aggressive hepatitis, and 1 definite posthepatic cirrhosis.