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Horizontal transmission of hepatitis B virus in children
1Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Republic of China.
Insights
Unsterilized, multiple intramuscular injections and sibling-to-sibling spread are key factors in horizontal hepatitis B virus (HBV) transmission among children in Taiwan. These routes contribute significantly to hepatitis B surface antigen (HBsAg) carriers.
Area of Science:
- Hepatology
- Virology
- Pediatrics
Background:
- Horizontal transmission of hepatitis B virus (HBV) accounts for a significant portion of hepatitis B surface antigen (HBsAg) carriers in Taiwan.
- Understanding transmission routes is crucial for preventing HBV infection in children.
Purpose of the Study:
- To investigate the primary routes and risk factors associated with horizontal HBV transmission in children.
- To compare HBV carrier children with seronegative children to identify differentiating factors.
Main Methods:
- A case-control study comparing 131 HBsAg carrier children with 98 age-matched seronegative children.
- Data collected via questionnaire survey on family size, kindergarten attendance, injection history, and HBV status of household contacts.
Main Results:
- Carrier children had a significantly higher frequency of intramuscular injections during infancy and toddlerhood.
- A higher prevalence of HBsAg positivity was observed among siblings of carrier children.
- No significant differences were found in family size, kindergarten age, or contact with carriers.
Conclusions:
- Unsterilized, multiple intramuscular injections represent a major route for horizontal HBV transmission.
- Intrafamilial spread, particularly among siblings, is a significant factor in childhood HBV acquisition.
- Targeted interventions should focus on safe injection practices and reducing sibling-to-sibling transmission.
Abstract:
Horizontal transmission of hepatitis B virus (HBV) is responsible for about half of the hepatitis B surface antigen (HBsAg) carriers in Taiwan. To investigate the routes and risk factors of horizontal HBV transmission, 131 HBsAg carrier children of HBsAg seronegative mothers were compared with 98 age-matched children seronegative for all hepatitis B markers. Possible factors influencing transmission of HBV, including family size, age at attending kindergarten, frequency of intramuscular injection during infancy and at the toddler stage, contact with HBsAg carriers, and HBV status of parents, siblings and caretakers were studied by questionnaire survey. Intramuscular injection frequency during infancy and at the toddler stage and prevalence of HBsAg positivity among siblings were significantly higher in carrier children than in the control group. Other factors studied were not different in these two groups. The results indicated that unsterilized, multiple intramuscular injections and intrafamilial spread among siblings might be the major routes of horizontal HBV transmission in children in Taiwan.