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Korean Journal of Epidemiology 1985;7(1): 28-43.
B형간염의 가족집적성에 관한 연구
권혁한
Familial clustering of hepatitis B virus
Hyuk Han Kwon
Abstract
The study of viral hepatitis type B has progressed much for the last decade, but the infection of hepatitis B virus is still prevalent all over the world. Especially in Korea, it is earnestly needed to study the immunology and epidemiology for HBV, to examine closely the cause for a familial clustering and to prevent it from spreading. Therefore the author sampled the students of 6 middle schools in Seoul from June 1984 till Septembre of the same year, measured the HBsAg with micro-Ouchterlony doubleimmuno diffusion modified method, and then detected HBsAg and anti-HBs in the serum by selecting families (total 898 persons) of 198 members (153 members of the HBsAg positive and 45 members of the HBsAg negative group) with the RPHA modified method. The results which were analyzed and compared with each other were as follows: 1. Familial clustering of HBV infection in the families which have chronic carriers (positive group) of Hepatitis B surface antigen (HBsAg). 1) The HBsAg positive rate of 701 family members of 153 carriers was 53.92%, higher than 3.05% of the control group, and the anti-HBs positive rate was 13.41% against 12.69% of the control group. But there was no significant difference statistically. The HBsAg positive rate (57.31%) of the families of female carriers was higher than that (50.01%) of the families of male carriers. The anti-HBs positive rate (15.65%) of the families of male carriers was higher than that (9.49%) of the families of female carriers. 2) The HBsAg positive rate in the parents (260 members) of carriers was 34.62%, and was significantly higher than that (2.78%) of the control group, but the anti-HBs positive rate was 16.92%, which was lower than that of the control group (19.44%). The HBsAg positive rate of parents in the case where the carrier was a son was 31.03%, and in the case where the carrier was a daughter showed higher value (41.68%). The HBsAg positive rate was significantly higher in the case of the mother (47.62%) than that in the case of the father (17.70%) and the anti-HBs positive rate was higher in the case of the father (23.89%) than that in the case of the mother(11.56%). 3) The HBsAg positive rate of the brothers and sisters of the carrier was 49.27%, which was higher than that of the control group (5.26%), and the anti-HBs positive rate was higher in the case group (17.52%) than that in the control group (9.21%). The HBsAg positive rate of the siblings was 59.06%, which was higher than that of the sisters (40.82%). The anti-HBs positive rate was 18.11% in the siblings and 17.01% in the sisters, which appeared to be similar. In the case of the male carriers, the HBsAg positive rate (61.97%) was significantly higher in their siblings (homosexual) than that (38.30%) in their sisters (heterosexual). But in the case of the female carriers, it (55.30%) was a little higher in the siblings (heterosexual) than that (45.28%) in their sisters (homosexual), which was statistically insignificant. 4) In the case of the grand parents of carriers, there was no HBsAg positive and the anti-HBs positive rate was 7.14%, But it was statistically insignificant because of the small sample cases. 2. In the sample cases (107) where parents of carriers existed, the cases where both of the parents were HBsAg positive was 8.41%, and the HBsAg positive rate was significantly higher in the case of the mother (50.47%) than that in the case of the father (17.76%). The anti-HBs positive rate was 2.80% in the case where both of the parents were positive, and the anti-HBs positive rate was significantly higher in the case of the father (24.30%) than that in the case of the mother (13.08%). 3. When the HBsAg positive rates were classified according to the number of family members, the case where all of the family members were HBsAg positive rate was 54.54% in the 2 member family group, 26.67% in the 3 member family group, 18.60% in the 4 member family group, and was 6.12% in the 5 member family group. In the family group of 6 members, the case where only 5 members in the family were HBsAg positive rate 17.86%, and in the family group of 7 members, the case where only 6 members in the family were HBsAg positive rate was 14.29%. The smaller the number of family members, the larger the probability that all family members are HBsAg positive. 4. HBsAg positive rates in relation to the related factors including liver diseases. 1) The HBsAg positive rate of members in the case where someone of their family died of liver disease was significantly higher (77.27%) than that (50.50%) in the counter case. When the causes of death were classified according to their frequencies, they were shown to be hepatoma, liver cirrhosis, and hepatitis in descending order. 2) HBsAg positive rate of the group whose members had experienced liver disease was 51.72%, and that of the counter group was 53.80%. There was no significant difference between the two groups. 3) HBsAg positive rate of the group whose members had experienced blood transfusion was 51.72% and that of the counter group was 53.80%. There was no significant difference between the two groups. 4) HBsAg positive rate of the group whose members had experience hospitalization or medical operation was 52.40% and that of the counter group was 34.44%. There was no significant difference between the two groups. 5) HBsAg positive rate of the group whose members experienced other diseases excepting liver diseases at that time was significantly higher (58.72%) than that of the counter group (50.00%). 6) HBsAg positive rate of the group whose members thought themselves healthy at that time was 54.48%, that of the group whose members thought themselves normal was 51.60%, and that of the group whose members thought themselves weak was 50.00%. But there was no significant difference among the groups. 5. HBsAg positive rates in relation to human living environment and related factors. 1) HBsAg positive rate of the group whose members owned house was 56.19%, that of the group whose members leased house on a deposit basis was 51.50%, and that of the group whose members leased house on a monthly rent basis was 45.90%. There was significant difference among these groups. 2) HBsAg positive rate of the group whose members used a single room by themselves was the highest (66.25%), and that of the group whose members used one room with other 4 persons was the lowest (45.00%). But there was no significant difference between the two groups. 3) HBsAg positive rate of the group whose members lived in 4 household houses was the highest (65.52%), and the group whose members lived in 6 household houses was the lowest (36.67%). But there was no statistically significant difference. 4) HBsAg positive rate of the group whose members used pump water as drinking water was 72.73%, that of the group whose members used well water was 63.16%, and that of the group whose members used tap water was 52.28%. But there was no statistically significant difference. 5) HBsAg positive rate of the group whose members used flush toilets was 55.42%, and that of the group whose members used conventional toilets was 51.13%. But there was no statistically significant difference. 6) In relation to religion, HBsAg positive rate of the Catholic group was the highest (58.33%), and Buddhist group was the lowest (45.58%). But there was no statistically significant difference. 6. The frequency that both the HBsAg and anti-HBs were detected in the same person was about 1%, which was detected in only 7 members among 701 members.


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