Prevalence of viral hepatitis B in an urban veteran spinal cord injured population

The objective of this study was to determine the prevalence of viral hepatitis B (HBV) seropositivity in an urban veteran population with spinal cord injury (SCI) and the relationship of liver function test (LFT) values to HBV seropositivity. Eighty patients with chronic SCI (44 inpatients and 36 outpatients) had liver function tests (LFTs), hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBsAb) and hepatitis B core antibody (anti-HBcAb) evaluated. Seventy-seven able-bodied (non-SCI) outpatients without known viral hepatitis risk factors served as an urban veteran reference group. Results demonstrated a high prevalence of seropositivity for HBV in both veteran groups (SCI = 29 percent; non-SCI = 22 percent). Subdividing the SCI group by inpatients and outpatients, HBV positivity was found to be significantly higher in the SCI inpatients than in either the SCI outpatient (39 percent vs 17 percent, x² = 4.67, p<0.05) or non-SCI groups (39 percent vs 22 percent, x² = 3.80, p=0.05). For the whole group, the gamma-glutamyl transpeptidase (GGT) level was greater in the HBV seropositive (n=40) compared with the HBV seronegative (n=117) populations (82 ± 17 vs 46 ± 7 U/L, p=0.019, respectively). In addition, the subgroup of spinal cord patients seropositive for hepatitis B (n=23) had a higher mean GGT than their seronegative (n=57) counterparts (101 ± 26 vs 47 ± 9 U/L, p=0.018, respectively). We conclude that urban veterans in general, and especially those inpatients with SCI, may be at increased risk of HBV infection. An HBV vaccination program for veteran patients with SCI may be warranted.