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U.S. OUTBREAKS OF HEPATITIS A TRIGGER ALERT

Outbreaks of hepatitis A among homosexual men could signal a resurgence of unsafe sex, federal health officials say.

Gay men aren't historically at high risk for the viral liver disease, but the Centers for Disease Control on Thursday reported outbreaks among homosexual or bisexual men in several cities in the United States, Canada and Australia."Our concern is that the increase in hepatitis A in homosexual men may reflect a return to unsafe sex practices, or a misperception regarding the relative safety of certain sexual behaviors," said Dr. Miriam Alter, chief of hepatitis epidemiology for the CDC.

"This increase may herald an increase in other sexually transmitted diseases," she said.

The virus typically enters the body orally, through lapses in hygiene that result in contact with fecal matter, such as in day-care centers or homes with children in diapers. CDC researchers say anal sex may be a factor in the outbreaks among gay males.

In the first half of 1991, 115 cases of hepatitis A were reported in two heavily gay neighborhoods in New York City. Seventeen cases were reported there during that period a year earlier, the CDC said.

In Denver, 24 cases of hepatitis A were reported among gay or bisexual men in the first half of last year, up from the typical incidence of zero to three cases.

In San Francisco, 186 male hepatitis A patients in the first 11 months of 1991 identified themselves as gay or bisexual, compared with 64 the year before. Gay or bisexual men accounted for 78 percent of the 1991 cases among males, up from 68 percent in 1990.