The modes of Transmission of Hepatitis B virusin Turkey; the impact of status of liver diseaseon transmission
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Dosyalar
Tarih
1999
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Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Araştırma, HBV'nin aile içi geçişini incelemek için, kesitsel bir çalışma olarak düzenlendi. Ayrıca, indeks vakalarda karaciğerin hastalık durumunun bu geçişe etkisi incelendi. Çalışmaya 180 indeks vaka (122 erkek ve 58 kadın, yaş ortalamaları 36.8 ± 10.6 yıl) ve onların 380 yakını ile kontrol grubu olarak da 100 sağlıklı birey (48 erkek ve 52 kadın, yaş ortalamaları 41.4±18.6 yıl) alındı. Katılanlarda HBV için serolojik belirteçler bakıldı. Biyokimyasal testler, ultrasonografi ve gerektiğinde karaciğer biyopsileri yapıldı. Eşlerde HBs Ag pozitifliği %5, kardeşlerde %41, çocuklarda %18, sağlıklı taşıyıcı yakınlarında %17 ve kronik hepatitli (KH) hasta yakınlarında %19 olarak bulunurken kontrol grubunda bu oran %7 idi. Taşıyıcı ve KH'li hasta yakınlarındaki HBV pozitifliği kontrol grubuna göre anlamlı olarak yüksek bulundu (p<0.05). KH'li hasta ve taşıyıcı yakınlarından HBV pozitif saptananlar karşılaştırıldığında ilk gruptakiler arasında daha fazla hepatitli olguya rastlandı (sırasıyla %62.5 ve %29) (p<0.05). Genel olarak, HBs Ag taşıyıcılığı ikinci dekad sonuna kadar %14 gibi sabit bir seviyeye ulaşmakta idi. Çalışma sonucuna göre, kardeşler arası bulaş (%41) gözönüne alındığında, horizontal yol HBV için Türkiye'de en önemli bulaş yoludur. Horizontal olarak HBV bulaşında kardeşler ve erkek çocuklar en yüksek riski taşımaktadır. Bu nedenle, tüm toplum aşılaması gerçekleştirilemiyorsa, yirmi yaş altındakiler ve indeks vakaların kardeşleri öncelikli olarak aşılanmalıdır.
A cross-sectional study was designed to evaluate the mode of transmission of HBV in household in Turkey. We also investigated the effect of the state of liver pathology of index cases on transmission. One hundred eighty index cases (122 male and 58 female with a mean age of 36.8±10.6 years) and their 380 relatives were included as the study group and 100 individuals (48 male and 52 female cases with a mean age of 41.4 ± 18.6 years) were recruited as a control group. We assayed the serological markers of HBV in participants. Biochemical tests, ultrasonography and liver biopsy were performed when necessary. The prevalence of HBs Ag positivity was 5% in spouses, 41% in siblings, 18% in children, 17% in relatives of healthy carriers, 19% in relatives of those index cases with chronic hepatitis (CH) while it was 7% in controls. HBV positivity among relatives of HBs Ag carriers and of those with CH were significantly higher than controls (p<0.05). There were more cases with liver disease among the relatives of index cases with CH (62.5%) than those of healthy carriers (29%) (p<0.05). HBs Ag carriage reaches a steady-state level of 14% until the end of second decade. Considering the rate of HBs Ag positivity (41%) among siblings of index cases, horizontal way is the most important mode for HBV transmission in Turkey. The siblings and male children are under serious risk for horizontal transmission of HBV. Unless a mass vaccination program is available, at least a vaccination program should cover first necessarily those less than 20 years of age and siblings of index cases.
A cross-sectional study was designed to evaluate the mode of transmission of HBV in household in Turkey. We also investigated the effect of the state of liver pathology of index cases on transmission. One hundred eighty index cases (122 male and 58 female with a mean age of 36.8±10.6 years) and their 380 relatives were included as the study group and 100 individuals (48 male and 52 female cases with a mean age of 41.4 ± 18.6 years) were recruited as a control group. We assayed the serological markers of HBV in participants. Biochemical tests, ultrasonography and liver biopsy were performed when necessary. The prevalence of HBs Ag positivity was 5% in spouses, 41% in siblings, 18% in children, 17% in relatives of healthy carriers, 19% in relatives of those index cases with chronic hepatitis (CH) while it was 7% in controls. HBV positivity among relatives of HBs Ag carriers and of those with CH were significantly higher than controls (p<0.05). There were more cases with liver disease among the relatives of index cases with CH (62.5%) than those of healthy carriers (29%) (p<0.05). HBs Ag carriage reaches a steady-state level of 14% until the end of second decade. Considering the rate of HBs Ag positivity (41%) among siblings of index cases, horizontal way is the most important mode for HBV transmission in Turkey. The siblings and male children are under serious risk for horizontal transmission of HBV. Unless a mass vaccination program is available, at least a vaccination program should cover first necessarily those less than 20 years of age and siblings of index cases.
Açıklama
Anahtar Kelimeler
HBs Ag, Horizontal Bulaş, Türkiye, HBV Taşıyıcısı, HBs Ag, Horizontal Transmission, Turkey, HBV Carrier
Kaynak
Türkiye Klinikleri Gastroenterohepatoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
3
