The epidemiology of hepatitis B in female prostitutes was studied in a cross-sectional survey of 467 prostitutes and 510 control prenatal clinic patients from Lima and Iquitos, Peru. Prostitutes reported a mean of 8.8 ± 6.7 years of active prostitution and a mean of 205 ± 137 sexual contacts in the month prior to the study. Hepatitis B surface antigen (HBsAg) was found in comparable percentages of prostitutes (1.7%) and controls (0.8%; P =.305). In contrast, seropositivity for both antigen and antibody markers (HBsAg, anti-HBs, or anti-hepatitis Bcore) was found in a significantly higher percentage of prostitutes than controls (67.0% vs. 10.0%; P <.0001). By multivariate analysis, both prostitution (odds ratio [OR] 14.6) and the number of years of exposure as a prostitute (OR 3.2 for 10 years of exposure at age 35 years) were significantly associated with seropositivity for hepatitis B markers when adjusted for age. In this study, the prevalence of HBsAg was not substantially increased in highly active female prostitutes compared with the general population, even though hepatitis B transmission was greatly increased. These data suggest that in adult women with a high level of hepatitis B infection, hepatitis B antigenemia may not persist as frequently as previously indicated in studies of other populations.
Bibliographical noteFunding Information:
From the US Naval Medical Research Institute Detachment, Servicio de Venereas del Callao y Universidad Nacional Mayor de San Marcos, and Hospital Materna Infantil San Bartolome Herrera, Ministerio de Salud, Lima, Peru
Received 13 November 1989; revised 5 February 1990. Informed consent was obtained from study subjects, and the research guidelines of the US Naval Medical Research Institute Committee for the Protection of Human Subjects were followed. Financial support: Naval Medical Research and Development Command, NNMC, Bethesda, MD (Work Unit 3MI62770A870ARI22). The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of the Navy or the Peruvian government. Reprints and correspondence: Dr. K. Craig Hyams, NMRI-IDD, 12300 Washington Ave., Rockville, MD 20852.