Hepatitis B virus infection and vaccination status of high risk people in Sydney: 1982 and 1991.
OBJECTIVE
To determine the change in prevalence of hepatitis B virus infection among "at risk" patients attending the Sydney Sexual Health Centre between 1982 and 1991 and to determine the hepatitis B vaccination status of the 1991 group.


METHODS
Consecutive patients attending the Centre between 1 July and 31 December 1991 who belonged to at least one of the following risk groups: men who have sex with men (n = 351); female prostitutes (n = 124); and injecting drug users (n = 153).


METHODS
Hepatitis B infection status was assessed on the basis of patient history and blood testing. All patients without a history of hepatitis B infection or vaccination were offered screening for serum markers of hepatitis B infection. Hepatitis B infection status was correlated with age, sex, country of birth, sexual behaviour and injecting drug use and was analysed separately according to risk category.


RESULTS
The prevalences of any hepatitis B marker were: men who have sex with men 38.2% (61.0% in 1982; P < 0.0001); local female prostitutes 14.1% (28.8% in 1982; P = 0.024); international female prostitutes 58.4%; and injecting drug users 42.0%. Of those in the 1991 sample without a history of hepatitis B infection, 27.6% of men who have sex with men, 27.9% of local female prostitutes, 18.2% of international female prostitutes and 7.1% of injecting drug users were vaccinated.


CONCLUSIONS
The significantly lower prevalences of serum markers of hepatitis B infection among men who have sex with men and local female prostitutes when compared with 1982 suggest widespread adoption of safer sexual practices. The high prevalence of chronic hepatitis B infection among international female prostitutes indicates a potentially significant source of sexually transmitted hepatitis B infection in Sydney. The low vaccination rates provide an argument for mass vaccination against hepatitis B.
Anderson
B
B
Sydney Sexual Health Centre, Sydney Hospital, NSW.
Bodsworth
N J
NJ
Rohrsheim
R A
RA
Donovan
B J
BJ
D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines; D006716:Homosexuality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D009517:New South Wales / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000150:complications; D015819:Substance Abuse, Intravenous / Q000150:complications; D014505:Urban Population; D014611:Vaccination / Q000706:statistics & numerical data*
D017325:Hepatitis B Vaccines