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SUMMARYA population of 488 HBsAg carrier individuals, from central Italy, classified on the basis of biochemical, clinical and histological parameters, was analysed for the presence of HBV-DNA in serum and its relationship with HBeAg/anti-HBe markers. The prevalence of HBV-DNA was 32·8% in chronic patients with biopsy-proven liver disease, and 20 and 4·3% respectively in asymptomatic carriers with and without altered ALT levels. The values in chronic patients were correlated with the histological activity.Concordance of HBV-DNA presence and HBeAg positivity was observed in only 61·4% of cases. However HBV-DNA prevalence in sera of anti-HBe positive individuals was very low in asymptomatic carriers with normal ALT levels (2·5%). Higher values were observed in anti-HBe positive chronic patients (15·8%) and in carriers occasionally found with changes in ALT without any other clinical sign of illness (16·7%). These data would indicate that HBV-DNA is the serological marker which is most closely related to liver disease.

A seroprevalence survey of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), was conducted using serum samples obtained from 5813 health care workers (HCWs) in five public hospitals in the Latium region of Italy, during the 1985 vaccination campaign against HBV. The seroprevalences of HBV, HCV and HIV were 23·3% [95% confidence interval (CI) = 22·3−24·4%], 2% (95% CI = 1·6−2·4%) and 0·07% (95% CI = 0·001−0·13%), respectively. In a logistic regression model, sex, increasing age, all job categories vs. physicians, dental treatment in the previous six months, and needlestick injury during the previous year were significantly associated with HBV. Conversely, no occupational and community risk factors, but only history of blood transfusion were significantly associated with HCV. Nevertheless, the documented risk of HCV as well as of HIV transmission through percutaneous and mucocutaneous exposure to blood and body fluids should lead to continued efforts to minimize risks of infection by enhancing the compliance of HCWs with vaccination against HBV and adherence to infection control measures, and by introducing safer devices and techniques.