Journal of Postgraduate Medicine
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Year : 1987  |  Volume : 33  |  Issue : 4  |  Page : 182-4  

Hepatitis B surface antigen (HBsAg) in patients attending S.T.D. clinic.

DU Antani, PK Rao, VV Parab, VV Kale, SA Kamat 
 

Correspondence Address:
D U Antani





How to cite this article:
Antani D U, Rao P K, Parab V V, Kale V V, Kamat S A. Hepatitis B surface antigen (HBsAg) in patients attending S.T.D. clinic. J Postgrad Med 1987;33:182-4


How to cite this URL:
Antani D U, Rao P K, Parab V V, Kale V V, Kamat S A. Hepatitis B surface antigen (HBsAg) in patients attending S.T.D. clinic. J Postgrad Med [serial online] 1987 [cited 2020 Nov 29 ];33:182-4
Available from: https://www.jpgmonline.com/text.asp?1987/33/4/182/5264


Full Text



 INTRODUCTION



HBsAg is the specific marker of the infection with hepatitis 'B' virus (HBV). The most accepted view was of exclusive transmission through blood products and blood contaminated surfaces. Krugman[9] described two more routes namely contagion and feco-oral route. These routes were very common in endemic hepatitis in developed countries. Further, reports came regarding possible role for homosexual and hetrosexual intercourse.[3],[5],[12] Hersh[5] observed that transmission is likely to occur between sexual partners and promiscuity helps in transmission as shown by high incidence of HBsAg and anti-HBs among prostitutes[1],[4] and in patients attending veneral disease clinic.[11] In view of this, the study was undertaken to assess the role of sexual contact in transmission of HBsAg and to detect carrier rate among patients suffering from STD.

 MATERIAL AND METHODS



The serum samples were obtained from 2041 patients attending the STD clinic-Beliasis Road, Bombay. All these patients were VDRL positive and their sera were tested for HBsAg by counter-immuno-electrophoresis (CIEP). CIEP was done by using agarose gel and standard electrophoretic apparatus and barbitone buffer as recommended by Kelkar et al.[7] The sera of 250 voluntary donors were also tested to provide a control for comparison.

 RESULTS



Of the 2041 patients (1764 males and 277 females and age ranging from 25 years to 45 years) 69 patients (67 males, 2 females) showed the presence of HBsAg by CIEP, thus giving a carrier rate of 3.38%. In contrast, 2 of 250 sera from voluntary donors showed the presence of HBsAg thus giving a carrier rate of 0.8%.

 DISCUSSION



Recent information has thrown much Might on hepatitis B virus transmission avid it indicates that contact with infectious material like blood, blood products or blood contaminated surfaces is necessary for transmission of hepatitis B virus.

Recent information has emphasised the sexual mode of transmission. This is due to high incidence of HBV infection among STD patients, prostitutes, and homosexuals.[2],[6],[10] In our study, the carriage rate of HBsAg in VDRL positive patients was 3.38% and in voluntary blood donors the carrier rate was 0.8%. Henigst[4] found the carrier rate of HBsAg in prostitutes to be 8 times more than in blood donors. Similarly, Frosner[1] found a high rate of anti HBs in prostitutes and this increased with their age and duration of profession. Kelkar et al[8] in their study detected HBsAg in 2-04% of VDRL positive patients. Panjarathinam[10] observed that 1.03% of syphilitic patients carried HBsAg in their blood by agar gel diffusion method.

From the above study, it is clear that HBV can be transmitted through the sexual route. It also indicates that sexual transmission of HBV does occur in our environment because the carrier rate in sera of STD patients is much higher than those of voluntary blood donors. All the patients were VDRL positive which indicates that they were all STD patient and all the patients were attending the V.D. Clinic which drains people from neighbouring thickly populated red light area Kamathipura and represents the sexually promiscuous population though the details of promiscuity in individuals cases were not available. The people in general must be aware of possibility of transmission of HBV through sexual route.

It is possible that CIEP technique used in the present study and in the study by other authors is less sensitive technique and does not detect low titre of antigen in STD patients and in healthy carriers. The newer and more sensitive techniques like ELISA, RIA, if used will detect more number of carriers.

 ACKNOWLEDGEMENT



The authors wish to thank the Medical Superintendent, Kasturba Hospital, Bombay, for allowing us to use the hospital material.

References

1Frosner, G.: Epidemiology of viral hepatitis. Amer. J. Med. Sci., 270: 320-322, 1975.
2Fulford, K. W. M., Dane, D. S., Caterall, R. D., Woof, R. and Danning, J. V.: Australia antigen and antibody among patients attending a clinic for S.T.D. Lancet, 1: 1470-1473, 1973.
3Heathcote, J. and Sherlock, S.: Spread of acute type B hepatitis in London, Lancet, 1: 1468-1470, 1973.
4Henigst, W.: Sexual transmission of infection associated with hepatitis B Antigen. Lancet, 2: 1395, 1973.
5Hersh, T., Melnick, J. L., Goyal, R. K. and Hollinger, F. G.: Nonparental transmission of viral hepatitis type B (Australia antigen associated serum hepatitis). New Eng. J. Med., 285: 1363-1364, 1971.
6Jeffries, D. J., James, W. H., Jefferiss, F. J. G., Macleod, K. G. and Willcox, P. R.: Australia (hepatitis associated) antigen in patients attending a veneral disease clinic. Brit. Med. J., 2: 455-456, 1973.
7Kelkar, S. S. and Niphadkar, K. B.: Agarose and counter-immuno-electrophoresis, (Letter) Lancet, 2: 1394-1395, 1974.
8Kelkar, S. S. and Phaltankar, P. G.: Sexual transmission of the hepatitis B virus. J. Assoc. Phy. Ind., 30: 99-100, 1982.
9Krugman, S., Giles, J. P. and Hammond, J.: Infectious hepatitis. Evidence for two distinctive clinical epidemiological and immunological types of infection. J. Amer. Med. Assoc., 200: 365-373, 1967.
10Panjarathinam, R. and Prabhune, P. V.: Hepatitis B surface antigen in syphilitic patients. A preliminary report. J. Ind. Assoc. Communic. Dis., 5: 44-45, 1982.
11Schneider, J. King, L., Macnab, G. N. and Kew, M. C. HBsAg and its antibody in Black and White patients with veneral disease. Brit. J. Venerol. Dis., 53: 372-374, 1977.
12Wright, R. A.: Hepatitis B antigen and the HBsAg carrier in outbreak related to sexual contact. J. Amer. Med. Assoc., 232: 717-721, 1975.

 
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