Gupta Swati, Gupta Richa, Joshi Y K, Singh Sarman
Department of Laboratory Medicine, Division of Clinical Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Intervirology. 2008;51(1):7-13. doi: 10.1159/000118790. Epub 2008 Feb 29.
Familial clustering of HBV provides epidemiological evidence for the different modes of spread of the virus. Though the majority of the studies have addressed the issue of perinatal transmission in India, only a few reports have dealt with other modes of transmission.
The study was prospectively designed and data were collected from a total of 265 household contacts of 91 index patients with HBV-related chronic liver disease between January 2006 and July 2007. The prevalences of HBsAg and various antibodies; anti-HBs, anti-HBc and anti-HBe, were estimated in all household contacts using ELISA and VIDAS.
Among the various household contacts, the highest prevalence of HBsAg was seen in the pediatric age group (kids 1-15 years: 37.0%) and especially in siblings (48.3%), with statistical significance (p < 0.001). Hepatitis B virus (HBV) serological markers were found more commonly in contacts of female (68.8%) index patients as compared to males (p > 0.05). The development of anti-HBV antibodies showed an increasing trend with age (p < 0.001), with the highest prevalence in parents.
Horizontal transmission plays an important role in contributing to the high prevalence of HBsAg especially in young children. Hence, this age group needs to be targeted for primary prevention and effective vaccine.
乙肝病毒（HBV）的家族聚集性为该病毒不同的传播方式提供了流行病学证据。尽管大多数研究已探讨了印度围产期传播问题，但仅有少数报告涉及其他传播方式。
本研究为前瞻性设计，于2006年1月至2007年7月期间，从91例HBV相关慢性肝病索引患者的总共265名家庭接触者中收集数据。使用酶联免疫吸附测定法（ELISA）和VIDAS对所有家庭接触者的乙肝表面抗原（HBsAg）及各种抗体（抗-HBs、抗-HBc和抗-HBe）的流行率进行了估算。
在各类家庭接触者中，HBsAg流行率最高的是儿童年龄组（1至15岁儿童：37.0%），尤其是兄弟姐妹（48.3%），具有统计学意义（p < 0.001）。与男性索引患者的家庭接触者相比，女性索引患者的家庭接触者中乙肝病毒（HBV）血清学标志物更为常见（68.8%）（p > 0.05）。抗-HBV抗体的产生随年龄呈上升趋势（p < 0.001），父母中的流行率最高。
水平传播在导致HBsAg高流行率方面发挥着重要作用，尤其是在幼儿中。因此，这一年龄组需要作为初级预防和有效疫苗接种的目标人群。
