HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rosner, G Articles by Oren, R Search for Related Content PubMed PubMed Citation Articles by Rosner, G Articles by Oren, R

Acute hepatitis B in the era of immunisation: pitfalls in the identification of high risk patients

Liver Unit, Department of Gastroenterology and Hepatology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv, Israel

Correspondence to:
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

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.

Abbreviations: HBV, hepatitis B virus; ALT, alanine transaminase; AST, aspartate transaminase; HBsAg, hepatitis B surface antigen; anti-HBs Ab, antihepatitis B surface antibody

Keywords: acute hepatitis B; transmission; high risk heterosexual contact; Israel

This article has been cited by other articles:

				Hygieia J. Epidemiol. Community Health, July 1, 2006; 60(7): 648 - 648. [Full Text] [PDF]