Hepatitis B in a Highly Active Prostitute Population: Evidence for a Low Risk of Chronic Antigenemia

Abstract

The epidemiology of hepatitis B in female prostitutes was studied in a cross-sectional survey of 467 prostitutes and 510 control prenatal clinic patients from Lima and Iquitos, Peru. Prostitutes reported a mean of 8.8 +/- 6.7 years of active prostitution and a mean of 205 +/- 137 sexual contacts in the month prior to the study. Hepatitis B surface antigen (HBsAg) was found in comparable percentages of prostitutes (1.7%) and controls (0.8%; P = .305). In contrast, seropositivity for both antigen and antibody markers (HBsAg, anti-HBs, or anti-hepatitis B core) was found in a significantly higher percentage of prostitutes than controls (67.0% vs. 10.0%; P less than .0001). By multivariate analysis, both prostitution (odds ratio [OR] 14.6) and the number of years of exposure as a prostitute (OR 3.2 for 10 years of exposure at age 35 years) were significantly associated with seropositivity for hepatitis B markers when adjusted for age. In this study, the prevalence of HBsAg was not substantially increased in highly active female prostitutes compared with the general population, even though hepatitis B transmission was greatly increased. These data suggest that in adult women with a high level of hepatitis B infection, hepatitis B antigenemia may not persist as frequently as previously indicated in studies of other populations.

United Kingdom National Guideline on the Management of the viral hepatitides A, B and C 2015

“…[52][53][54][55][56] Sex workers are also at higher risk. 57,58 . Other routes are: vertical (infected mother to infant), parenteral (unscreened blood and blood products, injecting drug users sharing needles, syringes and other 'works', occupational needlestick injuries, nonsterile acupuncture and tattoo needles).…”

Sexual transmission and prevention of the hepatitis viruses A-E and G

“…22 23 However, hepatitis B virus is also eYciently transmitted sexually during heterosexual and male homosexual contact. [24][25][26][27] HETEROSEXUAL TRANSMISSION Several studies have shown that heterosexual transmission is important in female sex workers [28][29][30] and their customers 31 in countries where the prevalence of HBV carriers is high. In one study of Peruvian female prostitutes, 59.8% had evidence of past hepatitis B infection and over the next 3 years the non-immune prostitutes became infected at 4.7% per year, excluding parenteral transmission.…”

“…28 Evidence of past or current hepatitis B infection was four to six times higher in non-drug using prostitutes than in controls in this and other studies and correlated with number of sexual contacts and sexually transmitted diseases. [28][29][30] Outside of prostitution, heterosexual transmission is still important as shown by the 40% transmission rates to non-immune spouses of patients with acute or chronic hepatitis B. 24 32 There are no clear data on the mechanism of transmission but it is assumed to be unprotected vaginal intercourse.…”

“…Most of the work on female sex workers has been performed in countries where there are a high number of cases and carriers. [28][29][30][31] Although the studies provide information on the eYciency of sexual transmission which is generally applicable, they do not provide data on the proportion of infections attributable to sexual transmission in other low prevalence areas. Evidence from the CDSC in England and Wales, countries with a low prevalence hepatitis B carriage (0.01-0.05% in blood donors), shows that heterosexual transmission accounts for only 18% of acute hepatitis B and there is no evidence that transmission to, or by, female sex workers is common.…”

YEMEK FABRİKASI VE LOKANTA PERSONELİNDE ELISA TESTİ İLE HBsAg ve ANTİ-HBs SONUÇLARI

“…Tuncel ve arkadaşları (33) ise, hayat kadınlarında bu oranlan % 8.9 ve % 50.5 olarak bildirmektedir. Hayat kadmlan HBV için önemli risk grubundadır (1,16,19,21). HBsAg pozitif annelerden transplasenter, özellikle perinatal bulaşlar olmakta ve kordon kanında % 0-80 HBsAg pozitifliği bildirilmektedir (5,26,32,33).…”