Horizontal Modes of Transmission of Hepatitis B Virus (HBV): A Systematic Review and Meta-Analysis
,
Abstract
Background: Horizontal transmission of hepatitis B virus (HBV) is a significant transmission route in households, among contact sport athletes and institutionalized individuals. Children often are infected by non-sexual close contacts with an increased tendency to become chronic carriers. Hence, the awareness about various high-risk behaviours leading to horizontal transmission in the community is essential. A systematic review and meta-analysis was carried out to assess quantitatively the pooled prevalence of horizontally transmitted HBV infection globally.
Methods: The study was started after ruling out registered or ongoing systematic reviews related to this topic in the PROSPERO database. The study protocol was documented in PROSPERO with a registration number CRD42021235165. We searched electronic databases for published articles in English between 1981 and April 2021 reporting horizontal modes of hepatitis B transmission among unvaccinated contacts. Meta-analysis was carried out in STATA version 13.0 (College Station, Texas 77,845 USA). The forest plots were constructed using metaprop package in STATA.
Results: Forty-one studies were systematically reviewed and 15 studies were qualified for the meta-analysis, including 1619 hepatitis B cases and 4869 contacts. The overall pooled prevalence of horizontally transmitted HBV infection among the contacts was 38% (95% CI 30%-46%). The pooled prevalence among 3,912 household contacts from nine qualified studies was estimated as 44% (95% CI 35%-54%). The pooled prevalence rates among institutionalized individuals and contact sport athletes were 30% (95% CI 23%-37%) and 18% (95% CI 5%-32%), respectively.
Conclusion: The likelihood of horizontal transmission of HBV is greater among household contacts of chronic carriers of HBV and institutionalized individuals.
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2. Schmit N, Nayagam S, Thursz MR, Hallett TB (2021). The global burden of chronic hepatitis B virus infection: comparison of country-level prevalence estimates from four research groups. Int J Epidemiol, 50(2):560-69.
3. Stasi C, Silvestri C, Voller F (2017). Emerg-ing Trends in Epidemiology of Hepatitis B Virus Infection. J Clin Transl Hepatol, 5(3):272-76.
4. World Hepatitis Day 2016: Fact sheet PDF. "Hepatitis B and C in the Americas" (Sólo en inglés). https://www.who.int/docs/default-source/searo/india/health-topic-pdf/factsheet-b-hepatitisday2016.pdf?sfvrsn=da61ef0_2
5. Than TT, Jo E, Todt D, et al (2019). High Environmental Stability of Hepatitis B Vi-rus and Inactivation Requirements for Chemical Biocides. J Infect Dis, 219(7):1044-48.
6. Komatsu H, Inui A, Sogo T, et al (2012). Tears from children with chronic hepati-tis B virus (HBV) infection are infectious vehicles of HBV transmission: experi-mental transmission of HBV by tears, us-ing mice with chimeric human livers. J In-fect Dis, 206(4):478-85.
7. Alter MJ (2003). Epidemiology of hepatitis B in Europe and worldwide. J Hepatol, 39(Suppl 1): S64-9.
8. Wang H, Men P, Xiao Y, et al (2019). Hepa-titis B infection in the general population of China: a systematic review and meta-analysis. BMC Infect Dis, 19(1):811.
9. Yazie TD, Tebeje MG (2019). An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia. BMC Infect Dis, 19(1):917.
10. Keane E, Funk A, Shimakawa Y (2016). Sys-tematic review with meta-analysis: the risk of mother-to-child transmission of hepa-titis B virus infection in sub-Saharan Afri-ca. Aliment Pharmacol Ther, 44(10):1005-17.
11. Moghaddasifar I, B. Lankarani K, Moosazadeh M, et al (2016). Prevalence of Hepatitis B Virus infection among Pregnant Women in Iran: A Systematic Review and Meta-analysis. Int J Cancer Prev, 9(6): e3703.
12. Lavanchy D (2008). Chronic viral hepatitis as a public health issue in the world. Best Pract Res Clin Gastroenterol, 22(6):991-1008.
13. Borgia G, Carleo MA, Gaeta GB, Gentile I (2012). Hepatitis B in pregnancy. World J Gastroenterol, 18(34):4677-83.
14. Davis LG, Weber DJ, Lemon SM (1989). Horizontal transmission of hepatitis B vi-rus. Lancet, 1(8643):889-93.
15. Moher D, Liberati A, Tetzlaff J, Altman DG (2009). The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA State-ment. PLoS Med, 6(7):e1000097.
16. Hepatitis B, Chronic | 2012 Case Definition (2012). https://ndc.services.cdc.gov/case-definitions/hepatitis-b-chronic-2012/
17. Drazilova S, Kristian P, Janicko M, et al (2020). What is the Role of the Horizontal Transmission of Hepatitis B Virus Infec-tion in Young Adult and Middle-Aged Roma Population Living in the Settle-ments in East Slovakia? Int J Environ Res Public Health, 17(9):3293.
18. Hurie MB, Mast EE, Davis JP (1992). Hori-zontal transmission of hepatitis B virus infection to United States-born children of Hmong refugees. Pediatrics, 89(2):269-73.
19. Doganci T, Uysal G, Kir T, et al (2005). Horizontal transmission of hepatitis B vi-rus in children with chronic hepatitis B. World J Gastroenterol, 11(3):418-20.
20. Gupta S, Gupta R, Joshi YK, Singh S (2008). Role of horizontal transmission in hepati-tis B virus spread among household con-tacts in north India. Intervirology, 51(1):7-13.
21. Study Quality Assessment Tools. National Heart, Lung, and Blood Institute (NHLBI) https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
22. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003). Measuring incon-sistency in meta-analyses. BMJ, 327(7414):557-60.
23. Egger M, Davey Smith G, Schneider M, Minder C (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-34.
24. Dhorje SP, Pavri KM, Prasad SR, Sehgal A, Phule DM (1985). Horizontal transmis-sion of hepatitis B virus infection in household contacts, Pune, India. J Med Virol, 16(2):183-89.
25. Porres JC, Carreño V, Bartolomé J, Gutiez J, Castillo I (1989). A dynamic study of the intrafamilial spread of hepatitis B virus in-fection: relation with the viral replication. J Med Virol, 28(4):237-42.
26. Abdool Karim SS, Thejpal R, Coovadia HM (1991). Household clustering and intra-household transmission patterns of hep-atitis B virus infection in South Africa. Int J Epidemiol, 20(2):495-503.
27. Craxi A, Tiné F, Vinci M, et al (1991). Transmission of Hepatitis B and Hepati-tis Delta Viruses in the Households of Chronic Hepatitis B Surface Antigen Car-riers: A Regression Analysis of Indicators of Risk. Am J Epidemiol, 134(6):641-50.
28. Cakaloglu Y, Kaymakoglu S, Okten A, et al (1992). Horizontal transmission of hepa-titis B virus infection. J Hepatol,15(1-2):265-66.
29. Chakravarty R, Chowdhury A, Chaudhuri S, et al (2005). Hepatitis B infection in East-ern Indian families: need for screening of adult siblings and mothers of adult index cases. Public Health, 119(7):647-54.
30. Alizadeh AHM, Ranjbar M, Ansari S, et al (2005). Intra-familial prevalence of hepati-tis B virologic markers in HBsAg positive family members in Nahavand, Iran. World J Gastroenterol, 11(31):4857-60.
31. Zervou EK, Gatselis NK, Xanthi E, et al (2005). Intrafamilial spread of hepatitis B virus infection in Greece. Eur J Gastroen-terol Hepatol, 17(9):911-15.
32. Salkic NN, Zerem E, Zildic M, et al (2009). Risk factors for intrafamilial spread of hepatitis B in northeastern Bosnia and Herzegovina. Ann Saudi Med, 29(1):41-45.
33. Takata K, Yamauchi E, Shakado S, et al (2020). Horizontal Transmission of Hep-atitis B Virus Genotype C Among Mem-bers of a Wrestling Club in Japan. Am J Case Rep, 21:e925044.
34. Tobe K, Matsuura K, Ogura T, et al (2000). Horizontal transmission of hepatitis B vi-rus among players of an American foot-ball team. Arch Intern Med, 160(16):2541-45.
35. Kashiwagi S, Hayashi J, Ikematsu H, et al (1982). An Outbreak of Hepatitis B in Members of a High School Sumo Wres-tling Club. JAMA, 248(2):213-14.
36. McPhillips JC, Collins JC, Spigland I (1984). Hepatitis B virus infections transmitted from retarded children to their families during brief home exposure. J Pediatr Gastroenterol Nutr, 3(1):69-71.
37. Van Damme P, Cramm M, Van der Auwera JC, et al (1995). Horizontal transmission of hepatitis B virus. Lancet, 345(8941):27-29.
38. Koc ÖM, Robaeys G, Yildirim B, et al (2018). Horizontal hepatitis B virus transmission through non-sexual close contact in Turkish chronic hepatitis B pa-tients living outside of Turkey. Acta Gas-troenterol Belg, 81(4):503-508.
39. Ucmak H, Faruk Kokoglu O, Celik M, Ergun UGO (2007). Intra-familial spread of hepatitis B virus infection in eastern Turkey. Epidemiol Infect, 135(8):1338-43.
40. Rice SG (2008). Medical Conditions Affect-ing Sports Participation. Pediatrics, 121(4):841-48.
41. WHO. Guidelines on hepatitis B and C test-ing (World Health Organization). https://www.who.int/publications/i/item/9789241549981
42. Sokal EM, Paganelli M, Wirth S, et al (2013). Management of chronic hepatitis B in childhood: ESPGHAN clinical practice guidelines: consensus of an expert panel on behalf of the European Society of Pe-diatric Gastroenterology, Hepatology and Nutrition. J Hepatol, 59(4):814-29.
43. Kidd-Ljunggren K, Holmberg A, Bläckberg J, Lindqvist B (2006). High levels of hepatitis B virus DNA in body fluids from chronic carriers. J Hosp Infect, 64(4):352-57.
44. McIntosh ED, Bek MD, Cardona M, et al (1997). Horizontal transmission of hepa-titis B in a children's daycare centre: a preventable event. Aust N Z J Public Health, 21(7):791-92.
45. Cancio-Bello TP, de Medina M, Shorey J, et al (1982). An institutional outbreak of hepatitis B related to a human biting car-rier. J Infect Dis, 146(5):652-56.
46. Livengood JR, Miller GE, Coulter D, Foster LR (1989). Hepatitis B and workers in in-stitutions for the mentally retarded: risk of infection for staff in patient care. Am J Prev Med, 5(3):170-74.
47. Limentani A, Elliott L, Noah N, Lamborn J (1979). An outbreak of hepatitis b from tattooing. Lancet, 2(8133):86-88.
48. Jafari S, Buxton JA, Afshar K, Copes R, Ba-harlou S (2012). Tattooing and risk of hepatitis B: a systematic review and meta-analysis. Can J Public Health, 103(3):207-12.
49. Mevorach D, Eliakim R, Brezis M (1992). Hepatitis B--an occupational risk for butchers? Ann Intern Med, 116(5):428.
50. Candan F, Alagözlü H, Poyraz O, Sümer H (2002). Prevalence of hepatitis B and C virus infection in barbers in the Sivas re-gion of Turkey. Occup Med (Lond), 52(1):31-34.
51. Mijch AM, Barnes R, Crowe SM, Dimi-trakakis M, Lucas CR (1987). An out-break of hepatitis B and D in butchers. Scand J Infect Dis, 19(2):179-84.
52. Kent GP, Brondum J, Keenlyside RA, et al (1988). A large outbreak of acupuncture-associated hepatitis B. Am J Epidemiol, 127(3):591-98.
53. Nelson NP, Easterbrook PJ, McMahon BJ (2016). Epidemiology of Hepatitis B Vi-rus Infection and Impact of Vaccination on Disease. Clin Liver Dis, 20(4):607-28.
54. Siebert DJ, PB Lindschau, Burrell CJ (1995). Lack of evidence for significant hepatitis B transmission in Australian Rules foot-ballers. Med J Aust, 162(6):312-13.
55. Kordi R, Neal K, Pourfathollah AA, Mansournia MA, Wallace WA (2011). Risk of Hepatitis B and C Infections in Tehranian Wrestlers. J Athl Train, 46(4):445-50.
56. Petersen NJ, Barrett DH, Bond WW et al (1976). Hepatitis B surface antigen in sali-va, impetiginous lesions, and the envi-ronment in two remote Alaskan villages. Appl Environ Microbiol, 32(4):572-74.
57. Martinson FEA, Weigle KA, Royce RA, et al (1998). Risk Factors for Horizontal Transmission of Hepatitis B Virus in a Rural District in Ghana. Am J Epidemiol, 147(5):478-87.
58. Ameen A, Sabeena S, Robin S, et al (2022). Circulating genotypes of Hepatitis, A Vi-rus in South west, East and North East India, 2017-2018. Med J Armed Forces India, 78(2):185-191
59. Mevis FM, Sabeena S, Sanjay R, et al (2019). Currently circulating genotypes of hepati-tis E virus in India, 2014-2018. Indian J Med Microbiol, 37(4): 563-68.
60. Nikitha S, Sabeena S, Robin S, et al (2019). The prevalence of anti-hepatitis C anti-body among acute febrile illness cases in Idar Taluk, Gujarat, West India. Indian J Med Microbiol, 37(2): 225-29.
61. Biswajyoti Borah, AjantaSharma, Debaji-tRabha, et al (2021). Co-circulation of dif-ferent genotype, sub-genotype and sero-types of hepatitis B virus (HBV) and its epidemiology in Assam: A north-eastern state of India. Indian J Med Microbiol, 39(3):352-57.
2. Schmit N, Nayagam S, Thursz MR, Hallett TB (2021). The global burden of chronic hepatitis B virus infection: comparison of country-level prevalence estimates from four research groups. Int J Epidemiol, 50(2):560-69.
3. Stasi C, Silvestri C, Voller F (2017). Emerg-ing Trends in Epidemiology of Hepatitis B Virus Infection. J Clin Transl Hepatol, 5(3):272-76.
4. World Hepatitis Day 2016: Fact sheet PDF. "Hepatitis B and C in the Americas" (Sólo en inglés). https://www.who.int/docs/default-source/searo/india/health-topic-pdf/factsheet-b-hepatitisday2016.pdf?sfvrsn=da61ef0_2
5. Than TT, Jo E, Todt D, et al (2019). High Environmental Stability of Hepatitis B Vi-rus and Inactivation Requirements for Chemical Biocides. J Infect Dis, 219(7):1044-48.
6. Komatsu H, Inui A, Sogo T, et al (2012). Tears from children with chronic hepati-tis B virus (HBV) infection are infectious vehicles of HBV transmission: experi-mental transmission of HBV by tears, us-ing mice with chimeric human livers. J In-fect Dis, 206(4):478-85.
7. Alter MJ (2003). Epidemiology of hepatitis B in Europe and worldwide. J Hepatol, 39(Suppl 1): S64-9.
8. Wang H, Men P, Xiao Y, et al (2019). Hepa-titis B infection in the general population of China: a systematic review and meta-analysis. BMC Infect Dis, 19(1):811.
9. Yazie TD, Tebeje MG (2019). An updated systematic review and meta-analysis of the prevalence of hepatitis B virus in Ethiopia. BMC Infect Dis, 19(1):917.
10. Keane E, Funk A, Shimakawa Y (2016). Sys-tematic review with meta-analysis: the risk of mother-to-child transmission of hepa-titis B virus infection in sub-Saharan Afri-ca. Aliment Pharmacol Ther, 44(10):1005-17.
11. Moghaddasifar I, B. Lankarani K, Moosazadeh M, et al (2016). Prevalence of Hepatitis B Virus infection among Pregnant Women in Iran: A Systematic Review and Meta-analysis. Int J Cancer Prev, 9(6): e3703.
12. Lavanchy D (2008). Chronic viral hepatitis as a public health issue in the world. Best Pract Res Clin Gastroenterol, 22(6):991-1008.
13. Borgia G, Carleo MA, Gaeta GB, Gentile I (2012). Hepatitis B in pregnancy. World J Gastroenterol, 18(34):4677-83.
14. Davis LG, Weber DJ, Lemon SM (1989). Horizontal transmission of hepatitis B vi-rus. Lancet, 1(8643):889-93.
15. Moher D, Liberati A, Tetzlaff J, Altman DG (2009). The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA State-ment. PLoS Med, 6(7):e1000097.
16. Hepatitis B, Chronic | 2012 Case Definition (2012). https://ndc.services.cdc.gov/case-definitions/hepatitis-b-chronic-2012/
17. Drazilova S, Kristian P, Janicko M, et al (2020). What is the Role of the Horizontal Transmission of Hepatitis B Virus Infec-tion in Young Adult and Middle-Aged Roma Population Living in the Settle-ments in East Slovakia? Int J Environ Res Public Health, 17(9):3293.
18. Hurie MB, Mast EE, Davis JP (1992). Hori-zontal transmission of hepatitis B virus infection to United States-born children of Hmong refugees. Pediatrics, 89(2):269-73.
19. Doganci T, Uysal G, Kir T, et al (2005). Horizontal transmission of hepatitis B vi-rus in children with chronic hepatitis B. World J Gastroenterol, 11(3):418-20.
20. Gupta S, Gupta R, Joshi YK, Singh S (2008). Role of horizontal transmission in hepati-tis B virus spread among household con-tacts in north India. Intervirology, 51(1):7-13.
21. Study Quality Assessment Tools. National Heart, Lung, and Blood Institute (NHLBI) https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
22. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003). Measuring incon-sistency in meta-analyses. BMJ, 327(7414):557-60.
23. Egger M, Davey Smith G, Schneider M, Minder C (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109):629-34.
24. Dhorje SP, Pavri KM, Prasad SR, Sehgal A, Phule DM (1985). Horizontal transmis-sion of hepatitis B virus infection in household contacts, Pune, India. J Med Virol, 16(2):183-89.
25. Porres JC, Carreño V, Bartolomé J, Gutiez J, Castillo I (1989). A dynamic study of the intrafamilial spread of hepatitis B virus in-fection: relation with the viral replication. J Med Virol, 28(4):237-42.
26. Abdool Karim SS, Thejpal R, Coovadia HM (1991). Household clustering and intra-household transmission patterns of hep-atitis B virus infection in South Africa. Int J Epidemiol, 20(2):495-503.
27. Craxi A, Tiné F, Vinci M, et al (1991). Transmission of Hepatitis B and Hepati-tis Delta Viruses in the Households of Chronic Hepatitis B Surface Antigen Car-riers: A Regression Analysis of Indicators of Risk. Am J Epidemiol, 134(6):641-50.
28. Cakaloglu Y, Kaymakoglu S, Okten A, et al (1992). Horizontal transmission of hepa-titis B virus infection. J Hepatol,15(1-2):265-66.
29. Chakravarty R, Chowdhury A, Chaudhuri S, et al (2005). Hepatitis B infection in East-ern Indian families: need for screening of adult siblings and mothers of adult index cases. Public Health, 119(7):647-54.
30. Alizadeh AHM, Ranjbar M, Ansari S, et al (2005). Intra-familial prevalence of hepati-tis B virologic markers in HBsAg positive family members in Nahavand, Iran. World J Gastroenterol, 11(31):4857-60.
31. Zervou EK, Gatselis NK, Xanthi E, et al (2005). Intrafamilial spread of hepatitis B virus infection in Greece. Eur J Gastroen-terol Hepatol, 17(9):911-15.
32. Salkic NN, Zerem E, Zildic M, et al (2009). Risk factors for intrafamilial spread of hepatitis B in northeastern Bosnia and Herzegovina. Ann Saudi Med, 29(1):41-45.
33. Takata K, Yamauchi E, Shakado S, et al (2020). Horizontal Transmission of Hep-atitis B Virus Genotype C Among Mem-bers of a Wrestling Club in Japan. Am J Case Rep, 21:e925044.
34. Tobe K, Matsuura K, Ogura T, et al (2000). Horizontal transmission of hepatitis B vi-rus among players of an American foot-ball team. Arch Intern Med, 160(16):2541-45.
35. Kashiwagi S, Hayashi J, Ikematsu H, et al (1982). An Outbreak of Hepatitis B in Members of a High School Sumo Wres-tling Club. JAMA, 248(2):213-14.
36. McPhillips JC, Collins JC, Spigland I (1984). Hepatitis B virus infections transmitted from retarded children to their families during brief home exposure. J Pediatr Gastroenterol Nutr, 3(1):69-71.
37. Van Damme P, Cramm M, Van der Auwera JC, et al (1995). Horizontal transmission of hepatitis B virus. Lancet, 345(8941):27-29.
38. Koc ÖM, Robaeys G, Yildirim B, et al (2018). Horizontal hepatitis B virus transmission through non-sexual close contact in Turkish chronic hepatitis B pa-tients living outside of Turkey. Acta Gas-troenterol Belg, 81(4):503-508.
39. Ucmak H, Faruk Kokoglu O, Celik M, Ergun UGO (2007). Intra-familial spread of hepatitis B virus infection in eastern Turkey. Epidemiol Infect, 135(8):1338-43.
40. Rice SG (2008). Medical Conditions Affect-ing Sports Participation. Pediatrics, 121(4):841-48.
41. WHO. Guidelines on hepatitis B and C test-ing (World Health Organization). https://www.who.int/publications/i/item/9789241549981
42. Sokal EM, Paganelli M, Wirth S, et al (2013). Management of chronic hepatitis B in childhood: ESPGHAN clinical practice guidelines: consensus of an expert panel on behalf of the European Society of Pe-diatric Gastroenterology, Hepatology and Nutrition. J Hepatol, 59(4):814-29.
43. Kidd-Ljunggren K, Holmberg A, Bläckberg J, Lindqvist B (2006). High levels of hepatitis B virus DNA in body fluids from chronic carriers. J Hosp Infect, 64(4):352-57.
44. McIntosh ED, Bek MD, Cardona M, et al (1997). Horizontal transmission of hepa-titis B in a children's daycare centre: a preventable event. Aust N Z J Public Health, 21(7):791-92.
45. Cancio-Bello TP, de Medina M, Shorey J, et al (1982). An institutional outbreak of hepatitis B related to a human biting car-rier. J Infect Dis, 146(5):652-56.
46. Livengood JR, Miller GE, Coulter D, Foster LR (1989). Hepatitis B and workers in in-stitutions for the mentally retarded: risk of infection for staff in patient care. Am J Prev Med, 5(3):170-74.
47. Limentani A, Elliott L, Noah N, Lamborn J (1979). An outbreak of hepatitis b from tattooing. Lancet, 2(8133):86-88.
48. Jafari S, Buxton JA, Afshar K, Copes R, Ba-harlou S (2012). Tattooing and risk of hepatitis B: a systematic review and meta-analysis. Can J Public Health, 103(3):207-12.
49. Mevorach D, Eliakim R, Brezis M (1992). Hepatitis B--an occupational risk for butchers? Ann Intern Med, 116(5):428.
50. Candan F, Alagözlü H, Poyraz O, Sümer H (2002). Prevalence of hepatitis B and C virus infection in barbers in the Sivas re-gion of Turkey. Occup Med (Lond), 52(1):31-34.
51. Mijch AM, Barnes R, Crowe SM, Dimi-trakakis M, Lucas CR (1987). An out-break of hepatitis B and D in butchers. Scand J Infect Dis, 19(2):179-84.
52. Kent GP, Brondum J, Keenlyside RA, et al (1988). A large outbreak of acupuncture-associated hepatitis B. Am J Epidemiol, 127(3):591-98.
53. Nelson NP, Easterbrook PJ, McMahon BJ (2016). Epidemiology of Hepatitis B Vi-rus Infection and Impact of Vaccination on Disease. Clin Liver Dis, 20(4):607-28.
54. Siebert DJ, PB Lindschau, Burrell CJ (1995). Lack of evidence for significant hepatitis B transmission in Australian Rules foot-ballers. Med J Aust, 162(6):312-13.
55. Kordi R, Neal K, Pourfathollah AA, Mansournia MA, Wallace WA (2011). Risk of Hepatitis B and C Infections in Tehranian Wrestlers. J Athl Train, 46(4):445-50.
56. Petersen NJ, Barrett DH, Bond WW et al (1976). Hepatitis B surface antigen in sali-va, impetiginous lesions, and the envi-ronment in two remote Alaskan villages. Appl Environ Microbiol, 32(4):572-74.
57. Martinson FEA, Weigle KA, Royce RA, et al (1998). Risk Factors for Horizontal Transmission of Hepatitis B Virus in a Rural District in Ghana. Am J Epidemiol, 147(5):478-87.
58. Ameen A, Sabeena S, Robin S, et al (2022). Circulating genotypes of Hepatitis, A Vi-rus in South west, East and North East India, 2017-2018. Med J Armed Forces India, 78(2):185-191
59. Mevis FM, Sabeena S, Sanjay R, et al (2019). Currently circulating genotypes of hepati-tis E virus in India, 2014-2018. Indian J Med Microbiol, 37(4): 563-68.
60. Nikitha S, Sabeena S, Robin S, et al (2019). The prevalence of anti-hepatitis C anti-body among acute febrile illness cases in Idar Taluk, Gujarat, West India. Indian J Med Microbiol, 37(2): 225-29.
61. Biswajyoti Borah, AjantaSharma, Debaji-tRabha, et al (2021). Co-circulation of dif-ferent genotype, sub-genotype and sero-types of hepatitis B virus (HBV) and its epidemiology in Assam: A north-eastern state of India. Indian J Med Microbiol, 39(3):352-57.
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| Issue | Vol 51 No 10 (2022) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i10.10977 | |
| Keywords | ||
| Contacts Hepatitis B Horizontal Household Prevalence | ||
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How to Cite
1.
Sabeena S, Ravishankar N. Horizontal Modes of Transmission of Hepatitis B Virus (HBV): A Systematic Review and Meta-Analysis. Iran J Public Health. 2022;51(10):2181-2193.
