[Long-term experience with testing family and sexual contacts of HBsAg positive persons]. / Dlouhodobé zkusenosti s vysetrováním rodinných a sexuálních kontaktu HBsAg+ osob.

UNLABELLED: The study objectives were to identify HBsAg positive persons and to offer free vaccination against the infection to their family and sexual contacts found negative in screening for viral hepatitis B (VHB) postinfection markers. MATERIAL AND METHODS: Any person testing HBsAg positive in the Plzen region was registered in cooperation with laboratories. The collected data included reason for testing, clinical diagnosis and ethnicity. Contacts were screened for postinfection markers and vaccinated. RESULTS: Between 1997 and 2004, 939 HBsAg positive persons were registered by laboratories in the Plzen region. Their mean age was 42.2 (0-90) years. As many as 63.4 % of the infected persons appeared to be "healthy" carriers. Nevertheless, a significant upward trend in HBsAg positivity was recorded among immigrants (mainly those from Vietnam). Altogether 18.2 % of 829 family and sexual contacts tested positive for VHB postinfection markers (HBsAg, anti-HBc). The highest percentages of infected contacts were detected among siblings and parents of HBsAg positive persons (36.5 % and 27.3 %, respectively). Free vaccination has been requested by 82.2 % of susceptible contacts. CONCLUSION: Systematic vaccination of family and sexual contacts of HBsAg positive persons can contribute to more rapid VHB elimination in the Czech Republic. Currently, special attention in detecting infected persons is to be paid to immigrants from Asia.

[3-years' study of family contacts of HBsAg+ individuals]. / Tríleté zkusenosti s vysetrováním rodinných kontaktu HBsAg+ osob.

BACKGROUND: About 50,000 HbsAg carriers exist in Czech Republic. The most endangered group is the family members and sex partners. On the basis of positive HbsAg laboratory findings we decided to offer laboratory examination of post-infectious hepatic markers and to sero-negative also the vaccination against viral hepatitis B. METHODS AND RESULTS: The group of HbsAg carriers included 453 persons (253 males and 200 females), average age 42.3 years, within the range of 0 to 89 years. When samples were taken, 55.4% of examined persons were classified as "Healthy carrier". To offer of free examination and vaccination 410 family contacts responded. Postinfectious markers (HbsAg, antiHbsAg) were identified in 19.0% of examined persons, 78.3% of sensitive ones were vaccinated. When financial costs were evaluated, it is possible to conclude that examination and vaccination of contacts of HbsAg positive persons in the whole Czech Republic using the same method and similar collaboration may require 58.5 millions Kc. When laboratory tests were omitted, the costs may be reduced to 59.4%. CONCLUSIONS: On the basis of presented data authors deduce that the legislation of Czech Republic should be quickly changed to include the precept of free vaccination of family contacts of HbsAg positive persons. In accordance with it, rational method of depistage of those persons and information transfer should be developed. Considering long-term consequences of the viral B hepatitis, unreplaceable role in the prevention and diagnostics of the infection have general practitioners.