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目的调查广东省乙肝病毒(HBV)感染家庭聚集状况并分析其影响因素。方法选取2006年广东省乙肝血清学调查中发现的乙肝表面抗原(HBsAg)阳性人群及其共同居住生活的家庭成员为调查对象,调查内容包括问卷调查和实验室检测,问卷内容包括调查对象人口学资料和家庭内传播相关因素,实验室检测包括HBsAg、乙肝e抗体(抗-HBe)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)等指标。对数据进行描述性流行病学分析,并采用相对危险度(OR)衡量不同的人群特征出现家庭聚集性病例的风险变化情况。结果共调查到2006年广东省乙肝血清学调查发现的269户HBsAg阳性者及其家庭成员,193户(每户人口数≥2)中,有58户≥2例家庭成员HBsAg阳性,家庭聚集率为30.05%(58/193)。有家庭聚集性病例和无家庭聚集性病例的年龄构成分别为0~14岁(20.29%和7.41%)、15~55岁(69.57%和75.56%)、>55岁(10.14%和17.04%),职业构成分别为儿童及学生(27.54%和11.85%)、农民及工人(54.35%和62.22%)。两组的年龄及职业构成差异均有统计学意义(均P<0.01);相对于>55岁人群,0~14和15~55岁人群有家庭聚集性病例的可能性更大(OR=4.600、2.975),相对于儿童及学生,农民及工人有家庭聚集性的可能性更小(OR=0.376)。有家庭聚集性的病例HBeAg阳性和抗-HBe阳性者分别占41.91%和52.21%,而无家庭聚集性病例阳性比例分别为9.63%和85.19%,两者在两组中的差异均有统计学意义(均P<0.01),HBeAg阳性是HBV感染家庭聚集的危险因素(OR=6.771),抗-HBe阳性是HBV感染家庭聚集的保护因素(OR=0.190);有家庭聚集性的病例ALT和AST升高者分别占27.94%和21.32%,均高于无家庭聚集性病例的13.43%和9.70%,差异均有统计学意义(均P<0.01),ALT、AST升高均是HBV感染家庭聚集的危险因素(OR=2.499、2.523)。结论 HBeAg阳性、ALT和AST升高是HBV感染家庭聚集性的危险因素,其家庭成员更应注重个人防护。
Objective To investigate the status of hepatitis B virus (HBV) infection in Guangdong Province and analyze the influencing factors. Methods The HBsAg positive individuals and their co-residence family members found during the hepatitis B serological survey in Guangdong Province in 2006 were selected as survey subjects. The survey included questionnaires and laboratory tests. The questionnaires included demographic data Data and family-related factors, laboratory tests include HBsAg, hepatitis B e antibody (anti-HBe), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and other indicators. A descriptive epidemiological analysis of the data was performed and the relative risk (OR) was used to measure the risk of family aggregation among different population characteristics. Results A total of 269 HBsAg positive individuals and their family members were found in Guangdong hepatitis B serological survey in 2006, of which 193 (≥2) had HBsAg positive in ≥2 cases of family members, family aggregation rate 30.05% (58/193). The age of cases with familial aggregation and no family aggregation were 0-14 years old (20.29% and 7.41%), 15-55 years old (69.57% and 75.56%), 55 years old (10.14% and 17.04%), The occupational composition was 27.54% for children and students (11.85%) and peasants and workers (54.35% and 62.22%) respectively. There was a significant difference in age and occupational composition between the two groups (all P <0.01); family age at 0-14 and age 15-55 were more likely to have family clustering compared with those aged> 55 years (OR = 4.600 , 2.975). Farmers and workers are less likely to have family aggregation than children and students (OR = 0.376). Family aggregation cases of HBeAg-positive and anti-HBe-positive were accounted for 41.91% and 52.21%, respectively, while those without familial aggregation were 9.63% and 85.19%, respectively, and the differences between the two groups were statistically significant (OR = 6.771). The anti-HBe positive was the protective factor of HBV infection in family aggregation (OR = 0.190). The family aggregation of patients with ALT and AST were 27.94% and 21.32%, respectively, which were higher than those of 13.43% and 9.70% of those without family aggregation, the difference was statistically significant (all P <0.01), ALT, AST were elevated in HBV infected families Aggregated risk factors (OR = 2.499, 2.523). Conclusion HBeAg-positive, elevated ALT and AST are risk factors for HBV-infected family aggregation, and their family members should pay more attention to personal protection.