广东省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

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携带者配偶抗一HBc阳性率高于结婚5年以下者，差异有统计学意义（x。=4．88，P〈0．05），其中女性HBsAg携带者配偶抗一HBc阳性率更为显著（xz=6．39，P〈O．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。

Study on the risk of HBV infection among the spouses carrying HBsAg in Guangdong

Objective To investigate the risk of HBV infection among the spouses carrying hepatitis B virus surface antigen （HBsAg） and to provide a reference for developing strategies on hepatitis B control and prevention. Methods HBsAg carriers aged 20-45 years old and their spouses living in Guangdong province in 2006 were selected in this study.According to their residential areas, gender, age and age of marriage, corresponding HBsAg negative persons and their spouses were used as the control subjects. Both questionnaire type survey and serological methods were used in this investigation. HBV genotype was identified using the PCR method. Results Among the spouses of HBsAg carriers, the positive rate of HBsAg was 13.71%, while the rate was 8.06% for the spouse of HBsAg negative population.The anti-HBc rate was positively correlated with the age of marriage （X2=4.88, P〈0.05）, especially in the women （X2=6.39 ,P〈0.05）. HBsAg positive of spouse who did not use condoms （15.56%） is higher than that used （18.82%）. 16 couples were HBsAg carriers, and HBV were isolated from 8 couples. 5 couples were found to carry the same type B genotype and 2 couples were found to carry the type C genotype.Only 1 couple was infected with different HBV genotype. Conclusions The risk of HBV infection was high when the spouse was HBsAg carrier. Vaccination and the monitoring of the HBsAg are the preventive measures of HBV infection. Safe sex can reduce the incidence of HBV transmission between husband and wife.