HIGH CARRIER RATE AFTER HEPATITIS-B VIRUS-INFECTION IN THE ELDERLY

An outbreak of hepatitis B virus infection occurred in a nursing facil ity; it involved 31 patients with sequelae of cerebral vascular accide nts (15 men and 16 women; mean age, 77.4 +/- 9.3 yr). HBsAg disappeare d within 6 mo in 9 patients and persisted during an observation period of more than 6 mo in 13; the remaining 9 patients were lost to follow -up while they carried HBsAg. Thus 13 of 22 patients followed (59%) be came HBsAg carriers. We amplified a part of the S gene (436 nucleotide s) with polymerase chain reaction on hepatitis B virus DNA from 12 ran domly selected patients. The sequences of nine patients were the same as that of a nursing assistant who was an HBsAg carrier and suspected as the source of infection; it differed by only 1 or 2 (<0.5%) nucleot ides from those of the remaining three patients. Between the group of nine patients with transient HBV infection and the 13 patients with pe rsistent HBV infection, we found no differences in age or sex or in pa rameters of nutrition or immunocompetence. These results indicate a hi gh incidence of HBV carrier state in the elderly.