Article Text

PDF
Acute hepatitis B in the era of immunisation: pitfalls in the identification of high risk patients
  1. G Rosner,
  2. Y Lurie,
  3. L Blendis,
  4. Z Halpern,
  5. R Oren
  1. Liver Unit, Department of Gastroenterology and Hepatology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv, Israel
  1. Correspondence to:
 Dr Y Lurie
 Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel; dr_lurie{at}tasmc.health.gov.il

Abstract

Background: Since the adoption of a universal hepatitis B immunisation strategy, the reported incidence of acute hepatitis B has declined dramatically worldwide including in Israel. However, new cases of acute hepatitis B still occur. The aim of this study was to describe the incidence of acute hepatitis B in a referral area, routes of transmission, and outcome.

Methods: The charts of all new hepatitis B patients, who visited the clinic in the years 2002 and 2003 (January 2002 to December 2003), were reviewed. The main criteria for a diagnosis of acute hepatitis B were transient increase of alanine transaminase activity, and hepatitis B surface antigen seroconversion.

Results: Twenty nine men and seven women were diagnosed with acute hepatitis B infection during the study period. Two patients were previously vaccinated with hepatitis B vaccine. One case of hepatitis D coinfection was reported. The incidence of acute hepatitis B in the referral area was estimated as 2.25 per 100 000 adult population. Mean age was 36 years (17–75). Twenty one patients (18 men and 3 women) acquired the virus through unprotected sexual contact, and seven patients through iatrogenic exposure. Thirty three patients underwent spontaneous seroconversion while three patients became chronic carriers.

Conclusions: Despite a universal immunisation policy, frequent cases of acute hepatitis B in Israel are still seen. High risk heterosexual activity and iatrogenic exposure seem to be the commonest routes of transmission. Further recommendations regarding vaccination policy are discussed.

  • HBV, hepatitis B virus
  • ALT, alanine transaminase
  • AST, aspartate transaminase
  • HBsAg, hepatitis B surface antigen
  • anti-HBs Ab, antihepatitis B surface antibody
  • acute hepatitis B
  • transmission
  • high risk heterosexual contact
  • Israel

Statistics from Altmetric.com

Footnotes

  • Funding: none.

  • Conflicts of interest: none declared.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.