乙型肝炎病毒表面抗原携带者配偶感染乙型肝炎危险性研究

Study on the risk of HBV infection among spouses of HBsAg carriers

目的探讨乙型肝炎（乙肝）病毒（HBV）表面抗原（HBsAg）携带者配偶感染HBV危险性，为制定乙肝相关防控策略提供参考依据。方法选择广东和江西省2006年全国乙肝血清流行病学调查发现的20～45岁HBsAg携带者及配偶作为病例组，运用病例对照方法按居住地、性别、年龄及婚龄等因素配比选择HBsAg阴性者及配偶为对照组，开展问卷调查和乙肝血清学指标检测。利用PCR方法分析夫妻双方均HBsAg阳性的HBV基因型。结果HBsAg携带者配偶HBsAg携带率为13．21％，明显高于对照组配偶（6．29％），差异有统计学意义（X2=4．23，P〈0．05）；HBsAg携带者其配偶的携带率均高于HBsAg阴性者的配偶；HBsAg携带者配偶的HBsAg携带率与结婚年限、性生活频率呈正相关，并与安全性行为关系密切。21对HBsAg均阳性的夫妻中，13对PCR扩增HBV阳性，其中11对（84．62％）HBV基因型相同（8对HBV为B型，3对为C型），仅2对夫妻HBV基因型不同。结论HBsAg携带者配偶感染HBV风险高；提倡HBsAg携带者主动告知配偶，采取安全性行为或配偶及时接种乙肝疫苗等有效措施。

Objective To investigate the risk of HBV infection among the spouses of hepatitis B virus surface antigen （HBsAg） carriers and to provide a reference for developing strategies on hepatitis B control and prevention. Methods A case-control study including HBsAg carriers aged 20-45 years-old from the nationwide sero-epidemiological survey for Hepatitis B in both Guangdong and Jiangxi provinces in 2006, together with their spouses were selected as case group, while. HBsAg negative persons and their spouses were among the control groups, under the same residencial areas, gender, age and age of marriage to the HBsAg carriers. Questionnaire survey and hepatitis B serological markers detection were carried out, together with the HBV genotype detection among the HBsAg positive couples between husband and wife by PCR. Results Among the spouses of HBsAg carriers, the positive rate of HBsAg was 13.21%, while the rate was 6.29% for the spouse of HBsAg negative population, with difference statistically significant （X2=4.23, P〈0.05）. HBsAg positive rate among spouses of the case group was higher than that in the control group. Among the spouses of HBsAg carriers, the HBsAg rate was positively correlated with the age of marriage, frequency of sexual intercourse and condom use. There were 21 pairs of HBsAg carriers between husband and wife,and HBV were isolated among 13 pairs, and there were 11 pairs carrying the same HBV genotype, accounting for 84.62%. HBV genotypes would include 8 pairs of type B and 3 pairs of type C. However, only 2 pairs were infected with different HBV genotype. Conclusion High risks of HBV infection existed in the spouses of HBsAg carriers. It was important to ask the HBsAg carriers to take the initiative in informing their spouses, and carrying out the appropriate measures, such as safe sex or timely hepatitis B vaccination for the spouse of HBsAg carriers etc., so as to reduce the HBV transmission between husband and wife.