Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
HEPATITIS B VIRUS TRANSMISSION BETWEEN HOMOSEXUAL MEN: A MODEL FOR AIDS
Aids and Infections of Homosexual Men. Second Edition. Ma P and Armstrong D, eds. Boston, Butterworths, p. 99-107 1989.. Unique Identifier : AIDSLINE ICDB/90659642 Alter MJ; Francis DP; Viral Hepatitis Surveillance, Hepatitis Branch, Div. of Viral; Diseases, CDC, Atlanta, GA
Abstract:
Hepatitis B virus (HBV) transmission between homosexual men can serve as a model for AIDS. Until recently, groups recognized as being at high risk for infection with HBV were those traditionally associated with percutaneous needle exposures. In the last decade, other types of exposures, particularly sexual contact with HBV-infected individuals, have been recognized as possibly playing an important role in the transmission of this disease. Both experimental and epidemiologic observations suggest that effective transmission involving body fluids such as saliva and semen occurs only when these fluids contain blood or serum. The similarities between the epidemiologic patterns of HBV and HIV are striking. Qualitatively, the groups at risk of the two infections are similar. Individuals whose behavior involves multiple sexual partners or sharing of injection paraphernalia are at marked increased risk for infection by both viruses. As a result, the occurrence of both diseases is heavily weighted toward homosexual men and iv drug users. Both viruses are blood borne and both are effectively transmitted by sexual contact. Despite the similarities between HBV and the AIDS virus, there is a major virologic difference between these two agents that could have a profound epidemiologic effect. The difference is the proportion of infected individuals who become persistent carriers and, thus, form the reservoir of infection for others. For HBV, it is well accepted that approx 10% of infected adults will develop persistent, often lifelong, infection. For the AIDS virus, the proportion is much higher, probably over two-thirds. This high proportion of persistently infectious individuals has made, and will continue to make, interruption of transmission of the AIDS virus difficult. A case in point has been the homosexual male community, where concern about AIDS has resulted in a considerable decrease in the number of sexual partners, yet until recently, the concomitant increase in the number of infectious people left the risk of exposure essentially unchanged. In contrast, such modification of behavior resulted in a significant decrease in the incidence of hepatitis B in this group beginning in 1986. (49 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*TRANSMISSION Hepatitis B/*TRANSMISSION Hepatitis B Surface Antigens/ANALYSIS *Homosexuality Human Male Risk Factors Sexually Transmitted Diseases, Viral/TRANSMISSION MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
