The asymptomatic HB6-Ag carrier: auto- and heterologous perils

The asympatomatic carrier--usually discovered on offering to be a blood donor--presents a complex health problem which to date has received only "guarded" attention. These carriers may be dangerous, because they can transmit the HBs-Ag not only by parenteral but also by "nonparenteral" means, due to its presence in urine, feces, saliva, tears, semen, vaginal discharge, menstrual flow, breast milk, joint, ascitic and cerebrospinal fluids. The transmission by sexual contact is well established. Inapparent transmission may also occur from insufficient sterilization of instruments, by tatooing, ear piercing, by barbers, manicurists, dentists and by mosquitoes and bedbugs. Some of the characteristics of an asymptomatic HBs-Ag carrier seem to be: a young male, most often black, from a poor social and hygienic environment with a possible gene dependent immune deficiency state. Our experiences suggest that all newly admitted patients to the hospital personnel should have determinations of the presence of HBs-Ag in their blood, so that adequate steps can be taken to protect their contacts from infection.