ACUTE HEPATITIS-B IN EDINBURGH 1975-92 - A RETROSPECTIVE STUDY IN A POPULATION WHERE HUMAN-IMMUNODEFICIENCY-VIRUS IS HIGHLY PREVALENT

A retrospective study of notified hepatitis B virus (HBV) infection in Edinburgh during 1975-92 identified 525 acute cases. For 343 where a probable transmission route could be determined, 215 were due to share d equipment by injection drug users (IDUs), 29 to homosexual intercour se, 25 to heterosexual or household contact with IDUs, 21 to heterosex ual contact with infected non-IDU partners and 53 to various other or multiple routes. Cases were unevenly distributed geographically, parti cularly those among IDUs. The highest incidence within a post code dis trict was approximately 2.5 times that for all Edinburgh. Annual cases peaked in 1984 then declined to low levels in the early 1990s. This r eduction was most marked among IDUs, and may be ascribed both to chang ed injecting behaviour and decreased susceptibility within this group. The latter factor implies that HBV infections may be an unreliable gu ide to human immunodeficiency virus (HIV) infection in populations whe re HBV is highly prevalent.