In order to define the hazard of household exposure to patients with acute hepatitis B, in the absence of persistent hepatitis B surface antigen (HBsAg), 98 household contacts of 42 patients with the acute disease were interviewed and tested for HBsAg, antibody to HBsAg (anti-HBs), and serum transaminases shortly after identification and at 3-month intervals for at least 12 months. Most of the index cases with acute hepatitis B were young men and many had used illicit drugs parenterally before the onset of illness. Three of the household contacts had HBsAg detected on initial testing, and 2 of these were carriers with elevated serum transaminase levels. The 3rd HB-Ag-positive contact developed acute hepatitis within 2 weeks. This appeared to represent a coprimary infection. Fourteen contacts had anti-HBs on initial evaluation and were considered immune as a result of prior experience with hepatitis B. Of 81 susceptible contacts (neither HBsAg nor anti-HBs on initial screening), 13 were spouses or sexual partners and 2 of these developed acute hepatitis B at 4 and 6 months after the onset of illness in their respective index cases; another developed anti-HBs at 6 months. Thus, 3 (23%) of 13 exposed spouses or sexual partners developed evidence of hepatitis B infection during the surveillance period. In contrast, no evidence of hepatitis B infection related to household exposure was found in 68 parents, siblings, and other domestic contacts. These data confirm the contagiousness of hepatitis B for household contacts of acute cases and suggest that the risk is confined to spouses and sexual partners. These persons appear to be prime candidates for prophylaxis with hepatitis B immune globulin. © 1977, American Gastroenterological Association. All rights reserved.
Koff, R. S., Slavin, M. M., Connelly, L. J. D., & Rosen, D. R. (1977). Contagiousness of Acute Hepatitis B: Secondary attack rates in household contacts. Gastroenterology, 72(2), 297–300. https://doi.org/10.1016/S0016-5085(77)80090-5