Management of the Asymptomatic Carrier of the Hepatitis-Associated (Australia) Antigen

Abstract

Routine testing of blood donors for hepatitis-associated antigen (HAA) may be expected to reveal over 10,000 asymptomatic carriers in the United States in the next year. These people will present a challenge to their physicians to separate those with potentially treatable liver disease from those requiring only reassurance and follow-up observation. From the public-health standpoint there is suggestive evidence that HAA can be spread from carriers by nonparenteral routes, and definite evidence that very small doses can cause disease after parenteral transmission. Health-care workers, because of increased exposure to the virus and a potentiality for spread to their patients by parenteral as well as oral means, present a special problem. They should undergo routine screening for HAA, both to reduce the opportunities for spread of the virus and to obtain much needed epidemiologic information. Identified carriers should be especially careful, but there is no current evidence that they should change their careers.