Type B and non-B viral hepatitis in Jerusalem

In a two-year survey of adult patients hospitalized with acute viral hepatitis in Jerusalem, 27% were reactive for the hepatitis B surface antigen (HB(s)Ag) by radioimmunoassay and therefore diagnosed as having hepatitis B. The majority of patients (73%) were non-reactive for HB(s)Ag and their diagnosis was non-B hepatitis ("type unspecifiable"). Thirty-one per cent of patients with hepatitis B and only 5% of patients with non-B hepatitis had histories consistent with parenteral transmission of hepatitis by blood transfusion or drug use. An additional 19% of the patients with hepatitis B had possible parenteral exposure and 50% had no obvious parenteral exposure, indicating that non-parenteral transmission of the hepatitis B virus (HBV) may be a significant epidemiological factor (50-69%) in the Jerusalem area. The prominent role of non-parenteral transmission of HBV is further evidenced by the relatively high prevalences of HB(s)Ag (0.97%) and antibody to hepatitis B surface antigen (anti-HB(s)) (19.0%) in healthy blood donors. These findings are consistent with the view that personal contact and intra-familial spread may be important factors in the epidemiology of HBV and indicate that non-parenterally transmitted HBV contributes significantly to endemic viral hepatitis in the Jerusalem area.