Hepatitis in aviation personnel

BACKGROUND: This study examines the specific etiologies and aeromedical outcomes of naval aviation personnel with hepatitis. METHODS: We searched the Biomedical Database of the Naval Aerospace Medical Institute for waiver requests for hepatitis. We reviewed the records for specific etiologies, possible risk factors, and the aeromedical outcomes of aviators who received waivers for chronic hepatitis. RESULTS: We examined 48 initial and 95 follow-up waiver requests for hepatitis for naval aviation personnel from July 1988 to May 2001. Initial waiver requests were for chronic hepatitis C (HCV) in 23 (47.9%), chronic hepatitis B in 17 (35.4%), and other etiologies in 8 (16.7%). Asian Americans, who comprise 2% of the aviator population in the Biomedical Database, accounted for a disproportionate number of waiver requests for hepatitis: 7 (14.6%) of the total and 6 (35.3%) of the aviators with HBV. Of the 48 aviators with hepatitis, waivers were granted in 32 (66.7%) cases, all of whom were asymptomatic. Waivers were denied to 16 (33.3%) aviators. One aviator with Hodgkin's disease in remission and one aviator with chronic HCV who became asymptomatic after treatment with interferon later received waivers for a total of 34 (70.8%) waivers. Two waivers were later revoked because of symptomatic HCV requiring interferon in one and incomplete physical exam in another. CONCLUSIONS: Aviation personnel who receive waivers for asymptomatic hepatitis occasionally present with symptomatic hepatitis, but most waiver recipients remain asymptomatic during their aviation careers.