European Journal of Pediatrics

, Volume 151, Issue 3, pp 188–191 | Cite as

Chronicity rate of hepatitis B virus infection in the families of 60 hepatitis B surface antigen positive chronic carrier children: Role of horizontal transmission

  • A. Vegnente
  • R. Iorio
  • S. Guida
  • L. Cimmino
Infectious Diseases


It is known that the 5%–10% of adults infected with hepatitis B virus (HBV) develop a chronic infection and that HBV infection acquired at birth by an hepatitis B surface antigen (HBsAg)/hepatitis B “e” antigen (HBeAg)-positive mother almost invariably leads to chronic infection. Little information is, however, available about the risk of HBV infection acquired in childhood becoming chronic. We have, therefore, studied the chronicity rate of HBV infection in the families of 60 consecutive HBsAg-positive chronic carrier children. Of parents 81.5% and 78.6% of children showed serological evidence of past or ongoing HBV infection. The chronicity rate was significantly higher among children (73.4%) than parents (35.6%). Such a high chronicity rate in these children was not correlated with vertical transmission, since this was reported in only 1.7% of them. It is noteworthy that the chronicity rate of HBV infection was not significantly different between children of HBsAg-positive mothers and those in whom infection must have been horizontally transmitted because their mothers were HBsAg-negative. Although the families studied represent a selected sample and the role of genetic factors could not be excluded, our results seem to show that the most important factor in determining the outcome of infection is the acquisition of hepatitis B during childhood.

Key words

Chronic hepatitis B Familial clustering Horizontal transmission Age of infection 



antibody anti hepatitis B “e” antigen


antibody anti hepatitis B surface antigen


hepatitis B “e” antigen


hepatitis B surface antigen


hepatitis B virus


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bortolotti F, Calzia R, Cadrobbi P (1986) Liver cirrhosis associated with chronic hepatitis B virus infection in childhood. J Pediatr 108: 224PubMedGoogle Scholar
  2. 2.
    Bortolotti F, Calzia R, Vegnente A (1988) Chronic hepatitis in childhood: the spectrum of the disease. Gut 29: 659–664PubMedGoogle Scholar
  3. 3.
    Bruguera M, Bosch J, Rodes J (1974) Familial clustering of hepatitis B antigen: a study in relatives of patients with liver diseases and hepatitis B antigenaemia. BMJ III: 495–497Google Scholar
  4. 4.
    Coltorti M, Del Vecchio-Blanco C, Caporaso N (1978) Prevalence of HBsAg, HBsAb and CALD in families of HBsAg or HBsAb positive subjects. International Congress Internal Medicine, Roma. Excerpta med Int Congr Ser, N. 502, p 559Google Scholar
  5. 5.
    Coltorti M, Del Vecchio-Blanco C, Caporaso N (1984) Familial clustering of HBV infection and chronic liver disease. Front Gastrointest Res 8: 169–179Google Scholar
  6. 6.
    Eliakim M, Ligumski M, Sandler SG (1978) Familial clustering and immune response in family contacts of patients with HBsAg positive liver cirrhosis. Am J Dig Dis 23: 407–412PubMedGoogle Scholar
  7. 7.
    Forzani B, Actis G, Verme G (1984) HLA-DR antigens in HBsAg-positive chronic active liver disease with and without associated delta infection. Hepatology 4: 1107PubMedGoogle Scholar
  8. 8.
    Franks AL, Berg CJ, Kane MA (1989) Hepatitis B virus infection among children born in the United States to southest Asian refugees. N Engl J Med 321: 1301–1305PubMedGoogle Scholar
  9. 9.
    Giusti G, Galanti B, Gaeta GB (1980) Epidemiology of viral hepatitis in Italy. Boll Ist Siet Milanese 1980; 59: 591Google Scholar
  10. 10.
    Hess G, Born M, Dormeyer H (1979) Hepatitis B virus markers among family contacts of asumptomatic HBsAg carriers. Scand J Gastroenterol 14: 373–377PubMedGoogle Scholar
  11. 11.
    Lindberg J, Lindholm A, Iwarson S (1977) Genetic factors in the development of chronic active hepatitis. Lancet I: 67–68Google Scholar
  12. 12.
    Nasrallah SM, Nassar VH, Skammaa MH (1978) Genetic and immunological aspects of familial chronic active hepatitis (type B). Gastroenterology 75: 302–306PubMedGoogle Scholar
  13. 13.
    Perrillo RP, Gelb L, Campbell C (1979) Hepatitis B e antigen, DNA polymerase activity, and infections of household contacts with hepatitis virus. Gastroenterology 76: 1319–1325PubMedGoogle Scholar
  14. 14.
    Singleton JW, Kohler PF, Merrill DA (1973) Infecvity risk of household contact with chronic carriers of hepatitis B antigen (HBsAg). Gastroenterology 64: 172Google Scholar
  15. 15.
    Szmuness W, Prince AM, Hirsch RL (1973) Familial clustering of hepatitis B infection. N Engl J Med 289: 1162–1166PubMedGoogle Scholar
  16. 16.
    Tong MJ (1990) The clinical consequences of perinatal infection of the hepatitis B virus. In: Coursaget P, Tong MJ (eds) Progress in hepatitis B immunization. Les Editions Inserm, pp 3–5Google Scholar
  17. 17.
    Toukan AU, Sharaiha ZK, Abu-El-Rub OA (1990) The epidemiology of hepatitis B virus among family members in the Middle East. Am J Epidemiol 132: 220–232PubMedGoogle Scholar
  18. 18.
    Van Hattum J, Geziena M, Schreuder TM (1987) HLA antigens in patients with various courses after hepatitis B virus infection. Hepatology 7:11–14PubMedGoogle Scholar
  19. 19.
    Vegnente A, Toscano P, Nuzzo V (1986) Natural history of HBsAg+chronic hepatitis in children. J Hepatol 1986; 3: S171Google Scholar
  20. 20.
    Vegnente A, Toscano P, Tarallo L (1988) Hepatitis B virus (HBV) carrier state and HLA antigens in 13 Italian families. Pediatr Res 24:418Google Scholar
  21. 21.
    Vegnente A, Guida S, Lobo-Yeo A (1991) T lymphocyte activation is associated with viral replication in chronic hepatitis B virus infection of childhood. Clin Exp Immunol 84:190–194PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • A. Vegnente
    • 1
  • R. Iorio
    • 1
  • S. Guida
    • 1
  • L. Cimmino
    • 1
  1. 1.Department of PaediatricsUniversity of NaplesNaplesItaly

Personalised recommendations