Familial aggregation transmission of hepatitis B virus infection and influencing factors for outcome

Li LIU; Lixian CHANG; Chunyan MOU; Yingyuan ZHANG; Huimin LI; Yu LUO; Junyi LI; Chunyun LIU

doi:10.3969/j.issn.1001-5256.2023.09.009

Volume 39 Issue 9

Sep. 2023

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Article Navigation > Journal of Clinical Hepatology > 2023 > 39(9): 2087-2095

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Familial aggregation transmission of hepatitis B virus infection and influencing factors for outcome

DOI: 10.3969/j.issn.1001-5256.2023.09.009

Li LIU^{1, 2},
Lixian CHANG²,
Chunyan MOU²,
Yingyuan ZHANG²,
Huimin LI²,
Yu LUO^{2
,
,
,},
Junyi LI^{2
,
,
,},
Chunyun LIU^{2
,
,
,}

1.
School of Government Management，Yunnan University，Kunming 650041，China
2.
Department of Liver Disease，Yunnan Clinical Medicine Center for Infectious Diseases，The Third People’s Hospital of Kunming，Kunming 650041，China

Research funding:

Practice and Innovation Project of Yunnan University (2021Y225)

More Information

Corresponding author: LUO Yu，49288408@qq.com（ORCID： 0000－0002－3748－207X）; LI Junyi，759725784@qq.com （ORCID： 0000－0002－0813－3989）; LIU Chunyun，751440760@qq.com（ORCID： 0000－0001－5343－5305）
Received Date: 2022-12-04
Accepted Date: 2023-02-23
Published Date: 2023-09-19

Abstract

Abstract

Objective To investigate the condition of hepatitis B virus （HBV） infection in Yunnan， China， in terms of familial aggregation， risk factors for transmission， and outcome， and to provide strategies for controlling the familial aggregation transmission of HBV. Methods The HBsAg－positive patients who were diagnosed in The Third People’s Hospital of Kunming from January 2015 to December 2017 were enrolled， and related data were analyzed， including demographic features and laboratory markers. The chi－square goodness－of－fit test for binomial distribution was performed for the families of the HBsAg－positive patients， and the familial aggregation rate was calculated. The univariate and multivariate Logistic regression models were used to analyze the risk factors for HBV transmission and new－onset liver cirrhosis or liver cancer. The Kaplan－Meier method was used to investigate the cumulative incidence rate of new－onset liver cirrhosis or liver cancer in HBsAg－positive patients， and the log－rank test was used for comparison. Results A total of 459 HBsAg－positive families were analyzed， involving 618 HBsAg－positive individuals and 918 HBsAg－negative individuals， and among these families， 107 had ≥2 HBsAg－positive family members， with a familial aggregation rate of 23.31% （χ²＝95.393， P<0.001）. The mode of transmission was mainly mother－to－child transmission. The multivariate Logistic regression analysis showed that sex （odds ratio ［OR］＝0.397， 95% confidence interval ［CI］： 0.270－0.584， P<0.001）， nationality （OR＝1.655， 95%CI： 1.035－2.648， P＝0.036）， monthly income （OR＝1.612， 95%CI： 1.094－2.375， P＝0.016）， shared sanitary appliance （OR＝2.789， 95%CI： 1.530－5.086， P<0.001）， liver cirrhosis at baseline （OR＝2.702， 95%CI： 1.404－5.203， P＝0.003）， total cholesterol （OR＝0.772， 95%CI： 0.657－0.908， P＝0.002）， and HBV DNA （OR＝2.063， 95%CI： 1.753－2.428， P<0.001） were independent influencing factors for the familial aggregation transmission of HBV. The 618 HBsAg－positive patients were followed up for a mean time of 4.80 years， with 85 cases （13.75%） of new－onset liver cirrhosis or liver cancer， and the Kaplan－Meier analysis showed that the families with familial aggregation transmission of HBV had a significantly higher cumulative incidence rate of liver cirrhosis or liver cancer than those without familial aggregation transmission （χ²＝10.629， P<0.001）. A stratified analysis was performed for the 618 HBsAg－positive patients based on the presence or absence of antiviral therapy and familial aggregation transmission of HBV， and the results showed that the patients who came from the family with familial aggregation transmission of HBV and did not receive antiviral therapy had the highest cumulative incidence rate of liver cirrhosis or liver cancer （32.50%）， while those who came from the family without familial aggregation transmission of HBV and received antiviral therapy had the lowest incidence rate of liver cirrhosis or liver cancer （3.33%）. Conclusion Familial aggregation is observed in HBsAg－positive individuals， and screening， health education， and follow－up observation should be strengthened for their family members. Antiviral therapy can effectively reduce the incidence rates of liver cirrhosis and liver cancer in families with aggregation transmission.
- Hepatitis B Virus,
- Disease Transmission， Infectious,
- Root Cause Analysis

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References(18)

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Familial aggregation transmission of hepatitis B virus infection and influencing factors for outcome

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