Evolution of acute hepatitis B in homosexual men to chronic hepatitis B. Prospective study of placebo recipients in a hepatitis B vaccine trial

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Abstract
The frequency of chronic hepatitis B in homosexual men was studied to determine if it reflects the high rate of acute hepatitis B or an altered respone to hepatitis B. Homosexual men (236) were prospectively followed up after entry into the placebo group of hepatitis B vaccine trial. Sixty-six participants (28.0%) developed hepatitis B 10-18 mo. after entering the study. Only 4 (6.1%) of the 66 had persistence of hepatitis B beyond 6 mo.; similar to reports in nonhomosexual subjects. The high rate of acute hepatitis B is the major factor contributing to the high prevalence of chronic hepatitis B in homosexual men, rather than an altered host response. Clinical features of the acute illness could not be used to identify patients who developed chronic hepatitis B.