摘要目的 了解上海市乙型肝炎(乙肝)感染者家庭成员HBV的感染状况,并分析其感染HBV的影响因素.方法 于2010年随机抽取上海市6个区的乙肝患者304例和HBsAg阳性者288例,对其本人及全部家庭成员进行调查,并采集静脉血5 ml检测乙肝血清学指标.按是否感染HBV分为病例组和对照组,进行单因素分析并拟合多因素logistic回归模型,探讨家庭成员感染HBV的影响因素.结果 全部592户1485名调查对象中有1137例感染HBV,总感染率为76.57％.共15种HBV感染模式,其中以抗-HBs和抗-HBc两项阳性,HBsAg、抗-HBe、抗-HBc三项阳性,抗-HBs、抗-HBe、抗-HBc三项阳性模式为主,构成比分别为30.69％、26.65％和10.03％.HBV感染年限与家庭成员中HBV感染人数构成比的差异无统计学意义.子女的感染率(42.86％)显著低于夫妻感染率(87.54％) (P＜0.001).经单因素和多因素分析,性别、年龄、共用餐具、乙肝疫苗接种史和口腔诊疗史是家庭成员感染HBV的影响因素(P＜0.05),而未接种乙肝疫苗、年龄40岁以上、年龄21～ 40岁、共用餐具、有口腔诊疗史、男性家庭成员的OR值分别为9.009、3.817、2.283、2.222、2.124和1.339.结论 上海市HBV感染呈明显的家庭聚集性.

abstractsObjective To understand the status of HBV infection among family members with HBV infected persons in Shanghai and to probe the determinants of HBV infection so as to provide evidence for improving the related strategies on hepatitis B prevention and control.Methods Three hundred and four hepatitis B patients together with 288 HBsAg carriers from 6 districts in Shanghai were randomly sampled in 2010.All the said persons and their families members were asked to fill in questionnaires and to be drawn 5 ml venous blood for HBV serologic indicators detection.The subjects were divided into case group and control group according to their status of HBV infection.Univariate analysis and multivariate logistic regression analysis were carried out to identify the determinants of HBV infection among family members.Results Among 1485 subjects from 592 households,a total of 1137 persons were infected by HBV,with the overall infection rate as 76.57％.Fifteen infection modes were noticed,in which double positive of anti-HBs and anti-HBc,triple positive of HBsAg,anti-HBe and anti-HBc,together with triple positive of anti-HBs,anti-HBe and anti-HBc accounted for the top three,with the proportions as 30.69％,26.65％ and 10.03％ respectively.The differences between the years of carrying HBV and the proportions of numbers that carrying HBV in families,were not statistically significant.The infection rate among children (42.86％) was significantly lower than that of their parents (87.54％)(P＜0.001).Results from both univariate and multivariate analysis showed that gender,age,utensil sharing,histories of receiving hepatitis B vaccines and dental outpatient service were determinants of HBV infection among families members (P＜0.05),with OR values being 9.009 for persons without immunization history of hepatitis B vaccines,3.817 for persons above 40 years old and 2.283 for persons of 21-40 years old,2.222 for families members who sharing utensil,2.124 for persons with history of dental outpatient service and 1.339 for male members,respectively.Conclusion Family clustering of HBV infection in was seen in Shanghai.In order to reduce the number of HBV infection in families,hepatitis B vaccination program need to be carried out.Healthy lifestyle should be emphasized to prevent HBV infection due to close contact.The risk of iatrogenic HBV transmission should also be prevented.