Serological Markers of Hepatitis Viruses in Patients and Contacts from a Low Prevalence
Population in South Hungary in 1994–2001
Ildikó Seress
1†, Younes Ali Saleh2, Judit Brojnás2, György Berencsi2, and László Nagymajtényi1
1 Department of Public Health, University of Szeged, Szeged, Hungary
2 Division of Virology, Béla Johan National Center of Epidemiology, Budapest, Hungary
† Deceased on 6 August, 2001.
Corresponding author: László Nagymajtényi
Department of Public Health
University of Szeged
Dóm tér 10
H-6723 Szeged, Hungary
Telephone: +36-62-545-119
Fax number: +36-62-545-120
E-mail: nml@puhe.szote.u-szeged.hu
CEJOEM 2003, Vol.9. No.4.: 243–252
Key words: Hepatitis A virus, hepatitis B virus, hepatitis C virus, multiple infections
Abstract: Between 1994 and 2001, more than 30,000 hepatitis virus marker-specific serological tests were
performed. Samples were taken from 17,994 persons suffering from hepatic disorders, and/or from
their family members, with the aim of detecting hepatitis virus markers in the population of South
Hungary. Hepatitis A virus (HAV)-specific antibodies, hepatitis C virus (HCV)-specific antibodies,
hepatitis B virus (HBV) surface antigen (HBsAg) were tested using commercial ELISA reagents. The
age of the persons was recorded at the time of blood sampling. In case the possibility of an acute
or chronic viral hepatitis was diagnosed, further samples were taken from the patients and their
family members were also sampled. The total number of persons of known age and residence with
serological markers was 1193 (6.6% of the total population studied). Of these, 66 (6.4%) had acute
epidemic hepatitis A infection. The number of persons with acute HBV infection or HBV carrier
state was 263 (21.8%), and 244 (20.6%) persons were found hepatitis C-positive. Multiple
infections (20 of 1193) were also identified. Five patients had acute HAV infection and probably
chronic HCV disease, four had HBV carrier state and acute HAV infection. In 3 patients, acute HAV
infection was combined with chronic carrier state of both HBV and HCV. Chronic carrier state of
HBV and HCV was supposed in 6 persons. Two persons had Helicobacter pylori seropositivity
complicating acute hepatitis. The etiology of 107 illnesses remained unclear. Introduction of
hepatitis E and G reagents might reveal the etiology of these and other cases, too.
The findings indicate that HBV or HCV carrier persons are at high
risk of HAV infections. The data confirm previous suggestions that septic infection
with Mycoplasma pneumoniae may cause acute hepatic disorders in the absence of both lung
involvement and hepatitis virus markers. The main practical suggestion from this work is to use
active immunisation of all persons suffering from chronic HCV disease with both HAV and HBV
vaccines (or HAV only if HBV carrier state was verified).
Received: 5 January 2004
Accepted: 17 February 2004