Brief report: Prevalence of hepatitis B and C virus infections in U.S. Air Force basic military trainees who donated blood, 2013-2016.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) can cause significant morbidity in military service members. Prevalences of HBV and HCV infections among military recruits accessioning into the U.S. Air Force have not previously been described. The Joint Base San Antonio-Lackland Blood Donor Center was queried for the results of HBV and HCV screening tests among all basic military trainees who donated blood between 25 November 2013 and 16 April 2016. Other active and reserve component members were excluded. The estimated prevalences of HBV and HCV infections among recruit blood donors were 0.0098% and 0.007%, respectively. This study suggests that the overall estimated prevalence of HBV and HCV infection is much lower among U.S. Air Force basic trainees, compared to other active and reserve component members and U.S. civilian populations. HBV and HCV viral infections can have a negative impact on mission readiness and individual deployment status, and have significant costs for the military. Additional studies are needed to determine cost effectiveness of screening for viral hepatitis among military populations.

Syphilitic hepatitis uncommon presentation of an old scourge.

BACKGROUND: Giant cell hepatitis is a rare entity in adults, accounting for 0.1% to 0.25% of liver disease in adults. Postinfantile giant cell hepatitis is often characterized by multinucleated giant cells on liver biopsy and a fulminant hepatitis. CASE REPORT: An active duty 36-year-old African-American male deployed to Kabul, Afghanistan, presented with jaundice 2 weeks after starting a testosterone analogue. He discontinued the supplement, but his jaundice persisted with up-trending bilirubin. Serologic testing was negative for hepatitis A, B, C, and E; cytomegalovirus; Epstein-Barr virus; herpes simplex virus; and human immunodeficiency virus. Evaluation for autoimmune hepatitis was negative. Magnetic resonance cholangiopancreatography was negative for obstruction. Liver biopsy revealed giant cell transformation of numerous hepatocytes and cholestatic hepatitis. Rapid plasma reagin was positive without physical findings. Treponema pallidum hemagglutination assays confirmed the diagnosis of latent syphilis. He was started on penicillin treatment with rapid improvement of bilirubin, creatinine, and hepatic synthetic function, all of which eventually normalized. CONCLUSION: Postinfantile giant cell hepatitis is a severe form of hepatitis that has several different potential etiologies, 2 of which were present in this patient: androgenic supplements and infection. This case highlights syphilis as an unusual but treatable cause of giant cell hepatitis. Testing for syphilis should be considered in any persistent liver injury.