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目的探讨广东省乙型肝炎(乙肝)病毒(HBV)表面抗原(HBsAg)携带者配偶感染HBV的危险性,为成人乙肝防控工作策略提供参考依据。方法采用病例对照方法,选择广东省2006年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,按居住地、性别、年龄及婚龄等因素配比选择当年HBsAg阴性者及配偶为对照组,进行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。结果病例组配偶HBsAg阳性率13.71%,对照组配偶HBsAg阳性率8.06%。结婚5年以上者HBsAg携带者配偶抗-HBc阳性率高于结婚5年以下者,差异有统计学意义(χ2=4.88,P<0.05),其中女性HBsAg携带者配偶抗-HBc阳性率更为显著(χ2=6.39,P<0.05)。性生活不使用安全套的夫妻配偶HBsAg阳性率(15.56%)高于性生活使用安全套的配偶(8.82%)。16对HBsAg均阳性的夫妻中,8对PCR扩增HBV阳性,7对(87.50%)HBV基因型相同;其中5对HBV为B型,2对为C型,仅1对夫妻HBV基因型不同。结论 HBsAg携带者配偶感染HBV风险比普通人群增高;在今后的成人乙肝防控工作中,需要加强对HBsAg携带者配偶HBV感染的监测及乙肝疫苗的接种,同时需要加强宣教,提倡安全性行为。
Objective To investigate the risk of HBV infection in spouses of carriers of hepatitis B virus (HBsAg) in Guangdong Province, and provide a reference for prevention and control of hepatitis B in adults. Methods A case-control study was conducted to select HBsAg carriers and spouses of 20-45 years old from Guangdong Province in 2006 for hepatitis B seroprevalence study. Patients with HBsAg-negative were selected according to their residence, sex, age and age. And spouse as control group, conducted questionnaire survey and hepatitis B serological test. HBsAg-positive HBV genotypes were analyzed by PCR in both spouses. Results The positive rate of HBsAg in case group was 13.71%, while the positive rate of HBsAg in control group was 8.06%. The positive rate of spouse anti-HBc in HBsAg carriers who were married more than 5 years was higher than that of those who married less than 5 years (χ2 = 4.88, P <0.05). The positive rate of spouse anti-HBc in female HBsAg carriers was more Significant (χ2 = 6.39, P <0.05). The positive rate of HBsAg in couples who do not use condoms (15.56%) is higher than that of condom in sex life (8.82%). Of the 16 couples who were positive for HBsAg, 8 were HBV positive and 7 (87.50%) had the same HBV genotype; 5 of them had HBV type B, 2 had C, and only 1 had different HBV genotypes . Conclusion The risk of HBV infection among spouses of HBsAg carriers is higher than that of the general population. In the future prevention and control of adult hepatitis B, it is necessary to strengthen the monitoring of HBV infection in spouses of HBsAg carriers and vaccination of hepatitis B vaccine. At the same time, it is necessary to strengthen the missionary education and promote safe behaviors.