Brewer T G, Oetgen W J, Dunn M A, Johnson L F
South Med J. 1980 Dec;73(12):1568-9. doi: 10.1097/00007611-198012000-00008.
We studied US soldiers hospitalized in Korea during 1977 because of acute icteric hepatitis. The clinical characteristics of this illness were similar to those noted in previous studies of this population. In contrast to earlier reports, however, hepatitis B virus was shown to be the single most important cause. Of 139 patients with acute viral hepatitis, 76 (55%) had positive tests for hepatitis B surface antigen (HBsAg) and 63 (45%) were HBsAg-negative on a single determination by radioimmunoassay (AUSRIA II) approximately one week after the onset of symptoms. Nonparenteral transmission was the primary mechanism of hepatitis B infection in this sexually active population. Only one patient had evidence of parenteral drug use. Our increased recognition of hepatitis B virus in these patients can be explained entirely by increased sensitivity of the current radioimmunoassay methods for HBsAg. High rates of nonparenteral transmission of B virus within the populations of developing countries are well recognized. Our findings show that hepatitis B virus can be the major cause of nonparenterally acquired acute hepatitis among foreigners in contact with such a population.
我们研究了1977年期间因急性黄疸型肝炎而在韩国住院的美国士兵。这种疾病的临床特征与此前针对该人群的研究中所记录的特征相似。然而，与早期报告不同的是，乙肝病毒被证明是最重要的单一病因。在139例急性病毒性肝炎患者中，76例（55%）乙肝表面抗原（HBsAg）检测呈阳性，63例（45%）在症状出现后约一周通过放射免疫测定法（AUSRIA II）单次检测时HBsAg呈阴性。在这个有性活动的人群中，非肠道外传播是乙肝感染的主要机制。只有一名患者有非肠道外用药的证据。我们对这些患者中乙肝病毒认识的提高完全可以用当前HBsAg放射免疫测定方法敏感性的提高来解释。在发展中国家人群中，乙肝病毒的非肠道外高传播率已得到充分认识。我们的研究结果表明，乙肝病毒可能是与这类人群接触的外国人中非肠道外获得性急性肝炎的主要病因。
