Natural history of liver disease in chronic hepatitis B surface antigen carriers. Survey of 100 patients from Great Britain.

100 consecutive British chronic carriers of hepatitis B surface antigen seen in a London teaching hospital are described. 77 were male homosexuals and only 19 had either symptoms or signs of chronic liver disease. 27 had normal liver function tests and 69 of the remaining patients had minimal changes, chronic persistent hepatitis, chronic active hepatitis, cirrhosis, or hepatocellular carcinoma diagnosed on liver biopsy. The 4 remaining patients did not have a biopsy but did have abnormal liver function tests. Chronic hepatitis B virus infection was an important cause of these conditions. Most patients showed no clinical, biochemical, or histological change during a mean follow-up period of 44 months, and only 9.7% spontaneously seroconverted from hepatitis B antigen positivity to become anti-hepatitis B e antibody carriers. Although the prognosis is good in the medium term, 7 patients died from hepatocellular carcinoma.

Rectal gonorrhoea in male homosexuals. Presentation and therapy.

In a review of rectal gonorrhoea 73 episodes were studied in 65 homosexual men. The presenting signs and symptoms were carefully noted. Treatment with a single injection of spectinomycin hydrochloride 2 g resulted in a cure rate of 94.5%. The relatively high treatment failure rate associated with rectal gonorrhoea may possibly be due to microbial mechanisms.

Liver disease among homosexual males.

5% of 2612 homosexual males attending genitourinary clinics were found to be hepatitis-B surface-antigen (HBsAg) positive. Liver biopsy was done in 25 who had abnormal liver-function tests but no symptoms or signs of liver disease, and 14 (56%) of these proved to have chronic active hepatitis or active cirrhosis. Neither the liver-function tests nor the viral markers in serum reflected the severity of the liver disease. 38% of a group of 118 HBsAg positive patients were HBeAg positive, and sexual contacts of these individuals may be at serious risk of infection.

The efficacy of cefuroxime for the treatment of acute gonorrhoea in men.

This is a report on a clinical trial in which cefuroxime was used for treating 110 men with uncomplicated urethral gonorrhoea. Twenty-three men were given 1 g cefuroxime intramuscularly and 1 g probenecid orally, and 87 were treated with 1.5 g cefuroxime intramuscularly with 1 g probenecid orally. All 18 patients treated with 1 g cefuroxime and 1 g probenecid and seen at least once after treatment, were cured. Sixty-six (98.5%) of 67 patients treated with 1.5 g cefuroxime and 1 g probenecid and seen at least once after treatment, were cured. No side effects were reported. The high cure rates compared favourably with other antibiotics now in regular use and cefuroxime should be of great value especially for patients infected with beta-lactamase producing gonococci.

Oral talampicillin in the treatment of gonorrhoea.

Talampicillin was effective in eradicating the causitive organism in uncomplicated gonorrhoea, with only four treatment failures (1-6%) in 245 patients seen at least once after treatment. Symptoms, such as discharge, were seen in 61 patients at some stage after treatment but 31 of these cases were clear after one or two follow-up visits. The anitbiotic was well tolerated. One patient developed a maculopapular rash, penicillin allergy was reported in two patients, and a generalised itch (possibly penicillin allergy) in one further patient. A total of 241 out of 245 (98%) cases had the urethral gonococcus successfully eradicated with talampicillin. Talampicillin given in single doses appears to be an extremely good choice of antibiotic in the treatment of uncomplicated gonorrhoea in men.

A 10-year study of homosexually transmitted infection.

A 10-year survey is presented of male cases of homosexually acquired infection seen between 1962 and 1971 at Charing Cross Hospital (West London Branch). Tables showing the number of cases of syphilis, gonorrhea, and other conditions in homosexual and heterosexual males and in females are considered. Tables of other relevant data are also presented. The reasons underlying the changes illustrated, including the Act legalizing homosexual practices between consenting adult males, which became effective in 1968, are discussed. Certain pathological conditions apparently connected with homosexual practices, such as serum hepatitis, local rectal disease, and mucous colitis, are included and also some relevant manifestations of herpes genitalis and genitral warts. Homosexually acquired infection in prisoners is described. Some of the psychiatric effects of homosexuality on clinic patients and also their fears of treatment at clinics are considered, as well as the behavioral differences in response to infection between exclusively homosexuals, bi-sexuals, and married homosexuals.

Amoxycillin in the treatment of gonorrhoea.

A series of 162 patients with uncomplicated genital gonorrhoea was assessed after single-dose treatment with 3 g. amoxycillin. This seems to be an acceptable method of treatment, resulting in clearance rates in both male and female patients of 99 and 95% respectively at the first follow-up. The default rates on follow-up over a 4-week period are also shown.