High carrier rate after hepatitis B virus infection in the elderly

Abstract

An outbreak of hepatitis B virus infection occurred in a nursing facility; it involved 31 patients with sequelae of cerebral vascular accidents (15 men and 16 women; mean age, 77.4 +/- 9.3 yr). HBsAg disappeared 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%) became HBsAg carriers. We amplified a part of the S gene (436 nucleotides) with polymerase chain reaction on hepatitis B virus DNA from 12 randomly 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%) nucleotides from those of the remaining three patients. Between the group of nine patients with transient HBV infection and the 13 patients with persistent HBV infection, we found no differences in age or sex or in parameters of nutrition or immunocompetence. These results indicate a high incidence of HBV carrier state in the elderly.

Molecular analysis of transmission of hepatitis C virus in a nurse who acquired acute hepatitis C after caring for a viremic patient with epistaxis

“…An outbreak of HBV infection from an HBV-positive health care worker with dermatitis in his hand occurred in 31 elderly persons living at a long-term nursing facility in Japan over a period of about 30 months [Kondo et al, 1993]. Of note, after the initiation of use of disposable gloves by the health care worker, however, no new cases of HBV infection occurred at that facility, indicating the occurrence of HBV transmission from a health care worker to patients via injured skin.…”

Status of Hepatitis B, C, E and a in Healthy Asymptomatic Persons and Child Bearing Age Groups Females in Varanasi, U.P., India

“…It is 2.6% in person between 17 to 55 years, while after 55 years it was 0.213%. In screening of elderly persons living in tents of Kumbh Mela also showed low positivity of HBsAg (1.19%).Hepatitis B infection is rare in most of the European countries in elderly persons [17] but a French study done in person over 65 years of age admitted in rehabilitation ward and nursing home revealed a very high carrier rate (16.7%) against 5% of adult population [17] Another study have done in old peoples and found a very high incidence of hepatitis B carrier (59%) [18] Probably in our country mostly elderly person becomes religious have less sexual activity and because of this incidence of hepatitis B carrier is less. Liver Function Test (LFT) done in 19 cases showed mild abnormalities in all cases but none of the person had elevated total bilirubin or direct bilirubin.…”

Hepatitis B virus infection among residents of a nursing home for the elderly: Seroepidemiological study and molecular evolutionary analysis

“…(B) Phylogenetic tree of the S gene sequences (681bp) of the study cases and 91 S gene sequences (681bp) retrieved from the DDBJ/EMBL/GenBank. only a few become carriers, however, the carrier rate after HBV infection is high among the elderly [Kondo et al, 1993], because of impairment of the cellular and humoral immune responses in the elderly. These reasons may be related to the high risk and facilitate spread of HBV among the residents of nursing homes for the elderly.…”

“…In the study that used genetic analysis to determine the transmission route of HBV infection in a nursing home for the aged, only point mutations in a part of the S gene sequence were compared [Kondo et al, 1993]. Analysis of the antigenic subtype of HBV or DNA sequence comparisons may provide supporting evidence for putative transmission [Zuckerman et al, 1995], but it is often difficult to discriminate between various HBV strains in countries like Japan where the one subtype of HBV is predominant [Shiina et al, 1991].…”

“…Several studies have recognized recently the epidemiology of HBV infection in such institutions in Europe and America [Foreani et al, 1992;Simor et al, 1992;Norman et al, 1999]. Similar data, however, in long-term care institutions have not been reported in Japan and few studies have reported the infection routes in such institutions by genetic analysis [Kondo et al, 1993]. In this study, a seroepidemiological study of HBV infection is described among residents of a nursing home for the elderly in Japan and elucidate the source of transmission of HBV among the residents of the institution using molecular evolutionary analysis based on the pre-S1 to S and the S gene nucleotide sequences of the HBV.…”