Abstract

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.