Viral Hepatitis: Problems of incidence and C o n t r o l in Military Personnel

(A) Hepatitis B virus, (HBV) is now the major cause of infectious virai hepatitis in U.S. military personnel and probably also in the eivifian population over 15 years of age. (B) T h e inci­ dence of icteric, viral hepatitis is much higher in U.S. military personnel than in comparable age groups in the civilian population. The 17to 20-year-old enlisted men show the highest rates. (C) In parts of the world (e.g., U.S.A., Germany) where most of t h e inapparent infection is caused by the adw subtype of HBV, most of the acute clinical disease is caused by the ayw subtype. In the U.S.A. and Germany, 95% or more of HB s Ag isolates from U.S. military personnel with acutc hepatitis is ayw. (D) It may be many years before one can expect to have sufficient da ta for a decision a s to t h e possible availability of an effective HBV vaccine. Accordingly, a decision is urgently needed regarding either the immediate use of the best practically available hepatitis immune gamma globulin, that can be prepared by modern techniques, for She prevention of hepatitis in U.S. military personnel o r postponement of such use until an adequate and properly controlled trial can be carried out in active duty military personnel in an area of high incidence.