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[Intrafamilial contagion with the hepatitis B virus]
F Giménez Sánchez1, F García García, M C Bernal Zamora
1Servicio de Aparato Digestivo, Hospital Universitario, Granada.
Insights
Hepatitis B virus (HBV) transmission within families is higher in those with chronic liver disease (CLD). High viral replication increases infectivity, underscoring the need for family member investigation and vaccination.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Investigating intrafamilial transmission of Hepatitis B virus (HBV).
- Examining the relationship between HBV transmission, viral replication, and epidemiological factors within families.
Purpose of the Study:
- To evaluate intrafamilial transmission patterns of HBV.
- To identify factors influencing HBV spread among family members.
Main Methods:
- Studied 106 chronic HBV carriers (79 asymptomatic, 27 with CLD) and their relatives (347 and 112, respectively).
- Assessed HBV markers (HBsAg, HBsAc, HBcAc) and HBV DNA in index cases and relatives.
- Conducted a survey on socioeconomic and cultural factors influencing transmission.
Main Results:
- Higher prevalence of HBV markers in relatives of patients with CLD compared to asymptomatic carriers and controls.
- Mother-child transmission was more significant in CLD cases, while other contacts were more infective in asymptomatic carriers.
- HBeAg and DNA-positive carriers demonstrated higher infectivity; socioeconomic factors had minimal influence.
Conclusions:
- Relatives of HBV carriers, especially those with high viral replication, face a significant transmission risk.
- Mandatory investigation and vaccination of relatives of HBV carriers are recommended.
- Understanding transmission dynamics is crucial for public health interventions.
Background:
A study of the intrafamilial transmission of the hepatitis B virus (HBV) and its relationship with the viral replication and epidemiological factors.
Methods:
The intrafamilial transmission of 106 chronic carriers of HBV was evaluated: 79 were asymptomatic carriers (AC) and 27 had chronic liver disease (CLD). Overall 347 relatives of the first group individuals and 112 of the second group were investigated. In the index cases, all HBV markers were investigated, and also DNA-HBV in those with CLD. In the relatives, HBsAg, HBsAc and HBcAc were investigated. Also, a survey to evaluate the influence of socioeconomic and cultural factors was also carried out.
Results:
The prevalence of markers was significantly higher in the relatives of patients with CLD (HBcAg, HBcAc and evidence of contact) followed by AC and controls. The most infective relation in AC was that of other contacts with significant differences from the mother-child relationship (HBsAc p less than 0.003, HBcAc p less than 0.01, and evidence of contact p less than 0.001). By contrast, in CLD the most infective relation was mother-child. The mother-child relation was more infective than the father-child one (HBsAg p less than 0.05, HBcAc p less than 0.03, and evidence of contact p less than 0.02). Regarding viral replication, it was found that the HBeAg and DNA positive patients were more infective. The prevalence of HBcAc and the evidence of contact increased with the time of living together of spouses. Finally, it can be stated in a general sense that, according to the results of the survey, the socioeconomic factors have a small influence on the familial transmission.
Conclusions:
The relatives of HBV carriers, particularly in the case of HC with high replication, have a high risk of transmission. Thus, their investigation and subsequent vaccination is mandatory.