Chakravarti A, Rawat D, Jain M
Department of Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi - 110 019, India.
Indian J Med Microbiol. 2005 Apr;23(2):128-30. doi: 10.4103/0255-0857.16055.
The purpose of this study was to determine the age wise prevalence of Hepatitis B virus (HBV) in children under five years and to analyze the relative importance of horizontal or vertical transmission. This study included 400 children in the age group of less than five years attending the outpatient department of pediatrics with minor complaints. History of HBV immunization was taken as the exclusion criteria. All the samples were tested for Hepatitis B surface antigen (HBsAg) and anti HBs using commercial ELISA kits. Liver function tests were performed on all the HBsAg positive patients. Hepatits B nucleocapsid antigen (HBeAg) was detected in few HBsAg positive mothers. Overall HBsAg positivity in children below five years was 2.25%. There was no statistically significant difference in HBsAg positivity in the different age groups by chi square test. HBsAg positivity in mothers was 4.25%. However only in three cases the pair of mother and child were both positive for HBsAg. The mean anti HBs positivity in children was 23.75%. There was no statistically significant difference in the anti HBs positivity in different age groups of children. The observation that there is no statistically significant difference in the prevalence of HBV infection (HBsAg and HBs) amongst different age groups of children below five years signifies that a large proportion of HBV infection in children of this age is acquired via vertical transmission. It is also indicated that this mode of disease transmission is responsible for the majority of chronic carriers. Universal immunization of all infants is desirable to decrease the carrier pool and it is inferred from the present study that Hepatitis B immunization should begin at birth to have greater impact.
本研究的目的是确定五岁以下儿童中乙型肝炎病毒（HBV）的年龄别患病率，并分析水平或垂直传播的相对重要性。本研究纳入了400名五岁以下因轻微不适到儿科门诊就诊的儿童。将乙肝疫苗接种史作为排除标准。所有样本均使用商用ELISA试剂盒检测乙肝表面抗原（HBsAg）和抗-HBs。对所有HBsAg阳性患者进行肝功能检查。在少数HBsAg阳性母亲中检测到乙肝核心抗原（HBeAg）。五岁以下儿童的总体HBsAg阳性率为2.25%。通过卡方检验，不同年龄组的HBsAg阳性率无统计学显著差异。母亲的HBsAg阳性率为4.25%。然而，只有三例母婴均为HBsAg阳性。儿童的平均抗-HBs阳性率为23.75%。不同年龄组儿童的抗-HBs阳性率无统计学显著差异。五岁以下不同年龄组儿童中HBV感染（HBsAg和抗-HBs）患病率无统计学显著差异，这一观察结果表明，该年龄段儿童中很大一部分HBV感染是通过垂直传播获得的。这也表明这种疾病传播方式是导致大多数慢性携带者的原因。对所有婴儿进行普遍免疫以减少携带者群体是可取的，并且从本研究推断，乙肝免疫应在出生时开始以产生更大影响。
