Hepatitis B surface antigen and antibody. A prospective study in asymptomatic drug abusers

The course of reactivity of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) in 238 asymptomatic heroin addicts entering methadone maintenance was followed up for periods of one to four years. On initial determination, HBsAg was seen in 39.1%, anti-HBs in 10.5%, and HBsAg and anti-HBs in 9.2%; only 41.2% of persons tested had no detectable titers of either antigen or antibody. Abnormal liver function was found initially in 83% with no significant difference between those with or without HBsAg and anti-HBs. At the conclusion of each study year, 50% to 60% of persons initially HBsAg-positive reverted to negative with HBsAg absent in all persons followed up through the fourth year of treatment. Anti-HBs persisted in two thirds of persons during the entire study. These results suggest that the HBsAg carrier state in addicts is not maintained if exposure is eliminated.