Seroepidemiology of hepatitis B virus in Israel. Results of a pilot study in Jerusalem

One thousand thirty-three native and immigrant Israelis, divided into 10-year age groups, were tested for the hepatitis B surface antigen (HBSAg) and antibody (anti-HBS). The prevalence of anti-HBS was 10.1%, increasing with age from the first (6.3%) through the fifth decade (16.2%) and declining slightly in the sixth and seventh decades. The age-adjusted prevalence of anti-HBS was higher for native Arabs (20.8%) compared with native Jews (4.8%), and for immigrants from North Africa (33.3%), compared with immigrants from the Middle and Near East (20.1%) and Western ("Ashkenazi") countries (8.5%). Acquisition of anti-HBS was not correlated with a past history of jaundice or of blood transfusion. Of the positive sera reactive for anti-HBS that were subtypable, 74% were anti-y and 26%, anti-d specific. The prevalence of HBSAg for the study population was 1.8%, resulting in a prevalence of hepatitis B virus (HBV) infection, past and present, of 11.9%. These findings indicate that, while HBV infection is prevalent in Jerusalem, the most common presentation is a non-icteric illness with an age distribution extending through early adulthood and not coinciding with the early childhood clustering characteristic of icteric hepatitis in the region. The serologic findings are consistent with other clinical and epidemiologic evidence that endemic hepatitis in Jerusalem is predominantly the result of infection by "non-B" viruses.