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Serologic Markers of Hepatitis A and B in the Population of Bali, Indonesia

Paul Brown^*, Georges Breguet, Linda Smallwood, Roland Ney, R. M. Moerdowo^¶ AND Robert J. Gerety

^* Laboratory of CNS Studies, NINCDS, NIH, Bethesda, Maryland
Department of Anthropology, University of Geneva, Geneva, Switzerland
Hepatitis Branch, Division of Blood and Blood Products, National Center for Drugs and Biologics, Bethesda, Maryland
Department of Human Genetics, CHUV, Lausanne, Switzerland
^¶ Faculty of Medicine, University of Udayana, Denpasar, Indonesia

A total of 343 sera from Balinese subjects in different age groups and geographic locations were tested by radioimmunoassay (RIA) for serum antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc); most sera were also tested for hepatitis B surface antigen (HBsAg), and for antibody to hepatitis A virus (anti-HAV). One hundred percent of the adult population was found to have anti-HAV, with antibody acquisition beginning in early childhood and reaching a level of 95% by the age of 10 years. Antibodies to hepatitis B virus were also frequent in young children, rapidly peaking to near 80% in older children and adolescents, then declining to a plateau that fluctuated between 40% and 60% throughout adult life. Overall, anti-HBc (49%) was detected slightly more often than anti-HBs (45%), but the relative frequencies of the 2 antibodies varied considerably from group to group. Despite these high antibody prevalences, HBsAg was detected in only 1.5% of the general population, and in no woman of child-bearing age. In utero infection is thus far less likely to account for the early acquisition of antibody to hepatitis B virus than inapparent percutaneous transmission occurring under conditions of close personal contact.

Accepted for publication November 21, 1984.