Preliminary Study Of The Risk With HBV Infection Among The Spouse Of HBsAg Carrier

BackgroundHepatitis B virus (HBV) is an infectious disease mainly transmitted through mother to child transmission, iatrogenic transmission and sexual contact.In China, with the hepatitis B vaccine (HepB) has been intergated into the Expanded Programme on Immunization(EPI) in2002, and the blood, blood products is strictly regulated and safe injection measures have been carried out, the proportion of HBV vertical and iatrogenic transmission is gradually decreasing, and the rate for HBV sexual contact will become HBV main route of transmission, but also the difficulties of adult hepatitis B prevention and control in China. The results of some survey show that:the hepatitis B virus surface antigen (HBsAg) carriers would spread the HBV into the spouses, and the HBsAg rate for the unvaccinizated spuoses of HBsAg carriers is from8.0%to15.4%(P<0.05) because the spuoses have infected HBV after marriage. It is suggests that it is risk for HBV transmission between husband and wife as long as that the husband or wife is HBsAg positive. HBV sexual contact is one important way that can not be ignored. However, the transmission risk for HBV sexual contact is preventable by carrying out effectively measures, for example safe sex and vaccinating HepB for the spouse of HBsAg carriers. However, due to China’s public can not be a proper understanding of HBV transmission and the prevention and control measures, a lot of prejudice against HBsAg carriers, and aslo HBsAg carriers fear of lack of understanding of the spouse or sexual partner, so the HBsAg carriers did not promptly inform the spouse (the sex partner), and had unsafe sexual action with their spouses (partner), those lead to his or her spouse (partner) with HBV infection.The National Hepatitis B serum epidemiological survey carried out in1979,1992and2006. And these results showed that HBsAg carrier rate is10%among the popilation aged20--45years old in China, and estimates the HBsAg carriers aged20--45years old is about70million. And these population is the mainly methods of HBV transmission by men-women sex because these population have active sexbehavior. Some Chinese scholars have carried out some of HBV sexual contact investigation and research, these studies were only a small number of clinical inpatient spouses through in HBV serological detection, and have not investigated the behaviors, psychological, protective measures and effects of HBsAg carriers and spouse (partner), these researches are disbenefitable in the assessment of the risk of HBV sexual contact in China.How to reduce the chance of HBV sexual contact in China,and further reducing the whole of HBsAg carrier rate is the new challenges and urgent topic for the hepatitis B prevention and control in China, it is necessary to carry out survey of the risk and strategies for the HBsAg carriers spread the HBV into their spouses or sexual partners, and explore the influencing factors of the HBV transmission in between the husband and the wife, thereby reducing the risk of transmission of HBV sexual contact, and eliminate public bias of HBsAg carriers, to provide a reference for the adjustment of hepatitis B prevention and control strategies in the future in China. ObjectiveCarrying out the risk survey among the spouse (partner) infects HBV through the sexual behavior with HBsAg carriers. And understanding the HBV infection status of HBsAg carriers spouse (partner) and the two sides of the psychological, behavioral change, effective preventive measures about the HBV, reducing the spread risk of HBV by sexual contact, eliminating the prejudices of the public on the HBsAg carriers, to provide a reference for adjustment of hepatitis B prevention and control strategies in the future in China.1. Carring out the questionnaires and HBV infection marker detection of HBV infection and preventive measures among HBsAg carriers and their spouse (partner), and evaluating HBV infection risk and the effect of preventive measures.2. Comprehensive analysis psychological, behavioral changes of HBsAg carriers and spouse (partner), and understanding the main factors that hinder the HBsAg carriers to take the initiative to inform the spouse or partner, providing reference data for eliminating public bias HBsAg carriers by carrying out targeted health education.Methods1. select the national viral hepatitis epidemiological survey in2006found HBsAg positive (including spouse) from Guangdong and Jiangxi Province as the case group, select the control group of of HBsAg-negative (including spouse) with, place of residence, gender, age, and married life similiar as the patient group. Carry out case-control study based on the1:1matching principle between the case group and control group and collected blood serum.2. Use the Abbott reagent of HBsAg, anti-HBs and anti-HBc detecting the all serum for survey object. Carry out PCR and gene sequencing for the HBsAg positive serum among case and control group, compare the couple HBV genome consistency.3. Designed database and analyze data using SPSS13.0software.Results1. HBsAg rate of the spouse of HBsAg carrier is13.21%, anti-HBc rate is70.44%; and the HBsAg rate of the spouse of HBsAg negative is6.29%, and anti-HBc rate is71.07%.2. Among159cases of HBsAg carriers,138cases inform the truth in timely to their spouses,7cases inform the spouses after heart tangled, only4cases have no intention to inform their spouse.45.91%of HBsAg carriers believe that the spouse can understand,43.40%of HBsAg carriers believe that the spouses will not be away from their. Among149cases informing their spouses, these are143spouses with abnormal reaction, and2spuoses with indifference, and4spouses with fear of contracting to stimulate.3. When the HBsAg carriers inform their spouses,51.57%the spouses does not matter and failed to take any protection measures,18.24%query data and seek scientific prevention, and28.93%encourage each other active treatment,23.27%vaccinate HepB in time and13.21%carry out the safe sexual behaviors.4. When the HBsAg carriers inform their spouses,62.89%the spouses can understand each other and take effective protective measures, and22.64%encourages the other carrying out the active treatment, but if not cured, will be away from.5. The results analyzed from318questionnaires showed that the correct answer rate about the HBV transmission of the mother to child, sexual behaviors, tattooing, sharing toothbrushes razor, lose blood, illegal iatrogenic is67.92%,46.54%,39.62%,47.17%,78.93%and46.23%respectively; the error answer rate about sharing meals can spread HBV accounted for44.03%.50%of respondents aware of the most common HBV prevention measures, such as regular hospital clinic, to avoid tattoo shaving and other traumatic beauty, safe sex, and HepB vaccinization. The survey also found:the rate of preventin HBV from television, radio and other media, medical workers, and hepatitis B posters, colleagues or friends, and hepatitis books is67.30%,55.03%,38.36%,34.91%and28.30%respectively, but only11.95%obtained the knowledge about HBV derived from the patients with hepatitis B or HBsAg carriers.6. Matching couple HBsAg positive specimens through PCR and gene, the results show, among13couples,8couples are B gene,3couples are C gene,1couple is husband with B gene and wife with C gene,1couple is husband with B gene and wife D gene.ConclusionThis study is the risk survey of the spouses infected HBV among the HBsAg carriers by using the epidemiological and molecular biological methods, and exploring the feasibility of HBsAg carriers inform spouses in time. The results show that the risk of the spouses infected HBV among the HBsAg carriers is great and that strategies of the HBsAg carriers inform the spouses in time is feasible, the study results also show that strengthening the IEC about HBV among the couples would promote they take effective protective measures preventing HBV transmission during their sexual behaviors.