AI Summary & Key Takeaways
AI InsightIn conclusion, the transmission rate of HBV infection among the family members was found high in our region and especially mothers played an important role for the transmission of the virus to their offsprings.
📌 3 Key Takeaways
Abstract
Hepatitis B virus (HBV) is one of the important causative agents of chronic liver disease in the world. Since HBV transmission is mainly by parenteral way and sexual contact, vertical (from infected mother to newborn) and horizontal (contact with infected subjects) transmission ways play important roles. The aim of this study was to retrospectively evaluate the intrafamilial transmission risk of HBV in our region. A total of 838 subjects (age range: 1-52 years; mean age: 19.5 years) whose parents were HBsAg positive and were admitted to our outpatient clinics in 2009, have been included to the study. Of them 389 (46.4%) had HBsAg positive mothers, 404 (48.2%) had HBsAg positive fathers and 45 (5.4%) cases had both parents as HBsAg positive. The rate of acutely infected subjects (HBsAg positive, anti-HBs negative) with HBsAg positive parents was 14.4% (121/838), the rate of non-infected susceptible subjects (HBsAg negative, anti-HBs negative) was 38.4% (322/838), and the rate of subjects who developed immunity (HBsAg negative, anti-HBs positive) was 5.3% (44/838). HBsAg positivity rate was found to be high in subjects whose mothers were HBsAg positive (25.2%; 98/389), than those whose fathers were HBsAg positive (2.5%; 10/404) and the difference was found statistically significant (p= 0.0001). Similarly the rate of HBV infection (HBsAg positive or anti-HBs positive subjects) among the offsprings whose mothers were HBsAg positive was determined to be higher (30.3%) than those whose fathers were HBsAg positive (8.2%) (p< 0.001). According to these data, the risk of HBV transmission was estimated to be three fold higher in subjects whose mothers were HBsAg positive than those whose fathers were HBsAg positive (OR= 2.96, 95% CI 2.109-4.156). In our study it was also detected that the rate of HBsAg positivity increased with age, being 10.3% (6/58) in children below 10 years old and increasing to 33% (29/88) in 11-20 years, 47% (31/66) in 21-30 years and 65% (26/40) in > 30 years age groups. There was no significant difference between consecutive age groups, however the difference between < 10 years and > 30 years age groups was found statistically significant (p= 0.0001). In addition having HBsAg positive mother or father did not affect HBV infection rate at 0-10 years age group, however, having HBsAg positive mother significantly increased the infection rate more than HBsAg positive father in 11-20 years and over 21 years age groups (p= 0.001 and p= 0.0001, respectively). In conclusion, the transmission rate of HBV infection among the family members was found high in our region and especially mothers played an important role for the transmission of the virus to their offsprings.
Özet
Dünyada kronik karaciğer hastalığının en önemli nedenlerinden biri olan hepatit B virusu (HBV)’nun bulaşı primer olarak parenteral yol ve cinsel temasla olmakla birlikte, gelişmekte olan ülkelerde vertikal (enfekte anneden yenidoğana bulaş) ve horizontal (enfekte kişilerle temas) yolla bulaşın da büyük önemi vardır. Bu çalışmada, bölgemizde HBV bulaşında aile içi geçiş riskinin retrospektif olarak değerlendirilmesi amaçlanmıştır. Çalışmaya, 2009 yılı içinde kliniğimize başvuran ve ebeveynleri HBsAg pozitif olan toplam 838 kişi (yaş aralığı: 1-52 yıl; yaş ortalaması: 19.5 yıl) dahil edilmiştir. Olgulardan 389 (%46.4)’unun annesi, 404 (%48.2)’ünün babası, 45 (%5.4)’inin hem annesi hem de babası HBsAg pozitiftir. Annesi ve/veya babası HBsAg pozitif olan bireylerin %14.4 (121/838)’ünün akut olarak enfekte olduğu (HBsAg pozitif, anti-HBs negatif), %38.4 (322/838)’ünün duyarlı kaldığı (HBsAg negatif, anti-HBs negatif) ve %5.3 (44/838)’ünün bağışıklık kazanmış olduğu (HBsAg negatif, anti-HBs pozitif) saptanmıştır. HBsAg pozitiflik oranı, annesi HBsAg pozitif olanlarda (%25.2; 98/389), babası HBsAg pozitif olanlara (%2.5; 10/404) göre oldukça yüksek bulunmuş ve bu farkın istatistiksel olarak anlamlı olduğu belirlenmiştir (p= 0.0001). Benzer olarak, HBV ile enfekte olanların (HBsAg pozitif veya anti-HBs pozitif) oranı da, annesi HBsAg pozitif olanlarda daha yüksek (%30.3) saptanırken, babası HBsAg pozitif olanlarda düşük (%8.2) bulunmuştur (p 30 yaş grubunda %65 (26/40)’e ulaştığı izlenmiştir. İstatistiksel değerlendirmede, birbirini izleyen yaş grupları arasında anlamlı bir fark saptanmazken, 30 yaş grubu arasındaki farkın anlamlı olduğu belirlenmiştir (p= 0.0001). Çalışmada ayrıca, 0- 10 yaş grubunda HBV ile enfekte olma açısından anne ya da babanın HBsAg pozitif olmasının bir etkisi olmadığı; ancak 11-20 yaş ve > 21 yaş grupları arasında annenin HBsAg pozitif olmasının HBV enfeksiyon oranını babaya göre önemli oranda artırdığı belirlenmiştir (sırasıyla; p= 0.001 ve p= 0.0001). Sonuç olarak, bölgemizde HBV enfeksiyonunun aile içi geçiş oranının yüksek olduğu ve özellikle annelerin bulaştırıcılıkta önemli rol oynadığı düşünülmüştür.