Intrafamilial transmission of hepatitis B and C among families of multi-transfused Egyptian children

ABSTRACT

Several studies have reported clustering of hepatitis B virus [HBV] and hepatitis C virus [HCV] infection in households. We aimed to measure the prevalence of HBV and HCV infections among family members of known HBV and/or HCV positive children, and to identify possible routes of intrafamilial transmission. 68 children with known HBV and/or HCV infections [index cases] were recruited. Blood samples were obtained from 303 of their family members for analysis for hepatitis B surface antigen [HBsAg] and HCV antibodies according to the index case status. A detailed questionnaire was applied to all study participants to investigate possible routes of medical, community and household infection. 2 relatives of the HBV infected index cases were positive for HBsAg [prevalence of 1.3% [21154]]. Both infected subjects were adults, were unvaccinated with HBV vaccine, had previous medical interventions, and had accompanied the index case during hospitalisation. No HBsAg infections were detected among siblings of HBV index cases, all of whom were vaccinated with the HBV vaccine. Prevalence of HCV infection among family members of HCV positive index cases was 9.3% [24/258], higher than the 4.4% [2/45] found among family members of HCV negative index cases. On logistic regression analysis, risk factors for HCV infection were older age, medical interventions, higher crowding index, and exposure to the blood of index cases. Sharing towels, beds, and eating utensils were not found to be associated with HBV or HCV infection. Absence of HBV infection among younger people in this study may be due to their high HBV vaccination coverage. There was a relatively higher prevalence of HCV infection among family members of HCV-infected index cases. Direct exposure to blood of the index case appeared to be the most important route of intrafamilial infection