HEPATITIS-B MARKERS IN HETEROSEXUAL PATIENTS ATTENDING 2 GENITOURINARY MEDICINE CLINICS IN THE WEST-MIDLANDS

Objective: To determine the prevalence of hepatitis B virus (HBV) infe ction in heterosexual patients attending two genitourinary medicine (G UM) clinics in the West Midlands and to examine whether heterosexual a ctivity is a risk factor for acquiring HBV infection with the view to extend HBV vaccination policies to cover this group. Design: HBV marke rs were determined in the GUM study group and compared with that of th e control groups. Responses to a questionnaire were used to examine se xual behaviour patterns that may be related to heterosexual acquisitio n of HBV infection. Setting: The West Midlands, UK April 1992-January 1993. Subjects: 788 male patients and 688 female patients attending GU M clinics were compared with 498 male blood donors and 563 females att ending antenatal clinics for the seroprevalence of HBV markers. Potent ial risk factors related to heterosexual activity were assessed in 143 6 patients in the study group. Main outcome measures: Prevalence of HB V markers in the GUM study group and the controls. The possible use of the risk factors examined as predictors for acquiring HBV infection. Results: The seroprevalence of hepatitis B core antibody (anti-HBc) in GUM patients was 1.9% and 0.5% in the control group. In the study gro ups the prevalence of anti-HBc from Birmingham was 3.2% while that fro m Coventry was 0.8%. The low seroprevalence of HBV prevented a multipl e logistic analysis. A limited regression analysis showed that being n on-white (p < 0.001) and duration of sexual activity (p = 0.013) were risk factors for HBV infection. However, these two factors were poor p redictors of the risk to exposure to HBV infection. Conclusion: The pr evalence of HBV infection in heterosexual patients in the West Midland s is very low and does not provide any indications to broaden HBV vacc ination into heterosexual patients attending GUM clinics. Risk factors were poor predictors of the exposure to HBV infection. This is partia lly due to the low prevalence of HBV infection in this study. Further studies are required before definitive conclusions are made regarding the potential predictive value of risk factors.