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Thesis Title

Nane

Ilegree

Thesis Supervisory

Date of Graduatiou

Abstract

This study focused on the rist factors for hepatitis B virus

infection in Kanphaengphet hospital personnel during April 1, 1989 to

llay 31, 1989. The target groups were Jauitors, Nursing-Aids,

La,boratory technicians, X-ray technicians, Assistaut nurses, Tecbnical

nursesrBegisterdd nurses, ,D,octors, Dentists, Dentical nurse and

Assistant dentists, particularly those rho rork in Ou; Patient

Departnent, Opthal clinicrEnergency roon, Operating roon, Laboratory-

blood bankr Dental clinicrGenter of supply, laundry unit, Nutritional

unit, Radiative unitrsocial nedicine unit, I[edicine and Surgery (narr),

Medicine and Surgery(girl), Surgery(nan)r Obstetrics, pediatrics,

clergy ward, Special ward, Personal histories, obtained through self-ad.inistered guestionnaire, and blood sanples were taken froa eyery

personnel.Serun sa"nples were exeniued for HBV narkers (IBsAg, Anti-

HBs, Anti-IIBc) in laboratory unit of Kanphaengphet hospital by BPHA

and PHA tecbniques.

Bisk factors for hepati.tis B virus infection

in.Ka.uphaengphet hospita.l personnel.

Suwaree llangsirigul

liaster of Science (Epideniology)

Connittee

Sonchai Supanvanich, I[. D. 1]l. P. E., lf . P. E. & T. H.

Anornrath Podhipak, M.S. (Biostatistics),

Ph.D. (Epideniology)

Sonsa.k tfattanasri, Ilt.D. rBoard of Ped.,

Cert. ln F.E;T.P.

26 ltlarch B.E. 2533 (1990)

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ICopyright by Mahidol University

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Ort of 326 lprsous in the target grbuB, bfood sa,nples and

conpleted questionnaires were obtained froa 2gB reslnndents (91.42).

rn 298 lrersons, there rere 42 rales (14.12), 2s6 felales (8b.gz), oyer

all HBV infection nas 53 per cent, carri.er (ttgslg, HBsAg + Anti-HBc)

8.7 Ber centl Anti-HBc 20.8 per cent. rununed Bersons (lnti-Rgs, Alti-f,Bs. + Anti-HEc) constituted 23 per cent of tbe target lnpulatlon.

Fanily incone Ber uonth of less lhen tQrQOO baht, age groups

of 30-34 and over 40 years, rorking period of nore than 10 yeers; past

history of 'blood .recipients, heterosexual experience, and narried

status were factors that significantly associated with HBY infection.

The results suggested that horizontal transnission acquired

both inside and outside hospitals Blayed significaot roles in the HBV

infection anorlg hospital p,ersonnel. In order to be trble to strengthen

effective prevention and control of HBY infection in Thai lnpulation,horizontal transulssion, via blood transfusion and sexual intercourse

nust be considered. On the basis of this study, vaccination of adults

is also reconmended whenever lnssible.

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b3 $itn{m'lr#xfid:sudr.rntrnnlufinniffincai-lfin nlunrrfrqrf;a

HBV tlUqnfl1fll .........'.................o........... 81

54 [6tn{n1'lrfrrfud:crir{nr:1rlnr::-nu'lu;omnurauri#r}rsI

duo'nrau rTunr:frnr$a IIBV 1Hjffn1n: ... o........ o....... gz

sE u6te{mlrtrrftrd:cu'ir{nrfififlm?n.lun:aunr-r6nr#o Hsvj

n-unr:finrfo HBv luuna'lni ..... ............ ... r.. gg

56 u6tnitn'l'lr#rjfird:cu'irtnr:fi rmftrftrfn-unr:ficr#o HBv

tlrrunatn: .....r....sT x6ln{n'l'lxf,rfrud:;H'ir.rnr:fiitffidnrtrmfifinr#o ott

fiunr:finr$o I{Bv luuna.tn: ............... ... ..... gs

sg r6tn\re"u1unr:finr#a rrBv q'lnn-l:rufiuuia-lrftrdnrrrnn

!t'luunn-lrrlntuR-lfiSll|: 6l

iouv/dofr inr -luc"lfrurifi:; nuu"u*ldg o . o s ...o.......... 87


IU

t

turnrn

ar:riqrnnuagff.rwri

ulutcADUOEUO{ hepatitis B virus lltAnnlunflO{inn5:dl|ttddrann:ou du'lnilu'lu zbzr000 ni'l

ffi:rit{rluasroufileuufrnirr 1 no{ HBv

AooXufluRlJu6ln{ Hnmunt|a'it rnnn.l:nn I da HBvI

nl:nt?esilttoufi l quuac uoufim6ffwirirsf:aft:'f,fiua-n r flu fi . .

usrrnifl:lr.ran'nfinm r ia{ rhiu r dut lonr:fin r iolr:-dn'tm-n l du frtl

luunn.ln:11{ nu'lu'lnnlllil{ l nil:I

ttuu'l

11

13

15

2

3

4

5a

98

I


taa

um

mtfl

t:nfiudn r nu r fiudiinniulr#.r usirtnrnnrnuflr teu8utu r n:finfieruri,r r^ur

urmunrcn{ tdu::srsdnurseir{ I uo{1rafir{ urinr:finurrurio'rfifid.rrrifinnuirr

' ufir eun:crtrrufl n,d. zsoe tdfi:rurrunr:frurilrou6reuufrnr,ririid.rl$rsrarmrdau

lurfioouo.tu'rrfiurfrottuyriuoontn:tfiu 1eu gtunberg (11 n"flriu'r1udnrrr,ru,f,ofi

r fiuer r raouor l:n uns riui'r r frunr: r flnfinnttuilnnafunr:finur, {oo r'r. oot tr{adudn r au

fi milfi{i6nr:drr,r t lunliorlqifiqdsrf,o

ii'udqirr:rr6{{nrrnn'uo-nrduernlr:-cfi $rurun'iruf, rfl nr:ruud'r

(e) ldut:uru#nunau0\rlrnrgrnufirfin$ufrnr:unrqldor€.odrfiolru5lru ruo:l'u rdod e. - i ^ I u . a-t, a -^Dt a d A e ail n. f, . enao r ilut:ffi s u-lo?r r nouunrsud{ nr:uanfrfiot rTulrvnnr nui}\t r.tua?r r uuoil r ua'gtl

rfrunruuuorttnfiudnrau fl fi,f;rtruifiruoridru unsdo "r ilrfiinrs{lunlixstnodrt:ndo

druyrrua.rfirfio$urTumsdrnsurlun;iu fier rrarrfiflifiudn-ur$rufinurrnsdrrnnunouuo{t!al

lnaqu0{truutt

trn't, ioq'uo-nrdu ufro fl rfiur:ofiorurdri"rrnnfi{rfiumnruort:nfimnn.ir

zoo #runu u€o {oaa, s uorurgurn:firtan rrutdtuvrno'',r,#.ruri{un:nrfiqqufu'r-uutr't tau..o.y;-J

IouNa'l'ludnlldsflnun8n'lt$yfin5cit'lutlnnn'lrtnululu$nnsmrn a{lt6lotlunrrrln 1I

rI


a

Prevalence Patterns of Hepatitis B virus

Prevalence HBsAg Anti-HBs

(z) (z)HB

childhood

neonatal

infection

Typical regions

a

Low

Moderate

High

0. 2-0. 5

8-10

4-6 infrequent

20-53 frequent

70-95 frequent

North Anerica

Central, Europe,

Australia

Eastern Europe,

Mediteranean,

Eastern Med. l

Japan, USSR

Tropical Africa,

Southern Asia,

Parts of China

2-7

a Source : Hepatitis World Health Forum 1983; 4 : 135-41.

runfrnrnfifio'n:rn'lrNdnua{mus{\t uisd'rdufinqsfinr:fint#o#.rusi r6n lriou

0T s fl) o'sri'1nr5rfio1:n uilsn1irfiufir?rcec6tir6tolur'urHnnnsr'uudlam rdoorumnH- A u , Z;;fiua'n:resaon{lUriOu "f (3) a'il,|{uilisrytetlnuotirufiufififiot1ildnilOirl5nflit unsl:n

6uo-nt;tudfinf,rfiur1rgr,rrRtd'Euaru:u rno rflo{ernnr5arouisNlnn'rnelu'ruurculn:'lufl

rf .rf . 2528 u:sNtru 52.z #runu fifirfiurn$sua{tinfifi{u:curfl s #runu r.rio{ouns{

10 uo\rUisurnslvru $nsu1nfiql:rurfirnrrruriauasnoufiuodtiirm-u qsvuirfifi.r{auns

-I--,-.arro60-80 uoit U:s dln:tnu ?.t tiu'irOt ndrUrtuliu[as 0 r ruinrnn E ]n:1u{ lunti r rl't:s'l-,1gt

lrnua{na{5tsu1aivru'r fiatrJrufinnrlu.r'lu'i'lrfiusr'uo-nrilu ufio fi rf,ur{ouns z 'luungfi!o

rfiau{ouns 9o lli:ugtfinuo.rrfo (4) (nrlT\tfi z) luclil1u{rl,uduo'nrtu ufio fi fiI

e

nn:ruo'rufiqs r fiu'hfioun'l1m1lctl mn du r fro{ Hrernfraetffeu a{ nrtifiedu rns rs uu


)

:'lu\t'tu odrlt:finrrut:nfruf,nl6tu q'lnl'lr-ilr:ru-rlun:rufito'nrrnrtrfioltnfiufrei{ru

nuryruluo'lusir,r I fiu nlmrd gnaorJdn;im'ir

rqfiurfuJrfliluulcN'lru 30,000 :ru d,rri rqsoitn'irnnruqi'rfir ro rrir (s)

;m:'l{n 2 Beported cases of Hepatitis, Thailaad, 1983-1987

6A 6et.q"ln6l0glU0it nlc nll\t 6n615t6lUNI^IUXUt9

1983 19851984 1986 1987

Total

Nunber Percenta

Hepatitis A

Hepatitis B

Non A, Non B

Hepatitis

UnsBecified

2764

59

22

1876

250

94

362

524

87

7660

1643

388

9.2

2.0

0.5

1938 720

286 524

72 113

8517 t2233 15568 20191 16975 73484 88. 3

a

Total 11 362 14453 L7864 2L548 17948 83175 100.0

source : Division of Epideniology, Ministry of public Health, Thailand

r flufiuoru:'urTu'irlrn1r:-dfru0-n r flu fi r flur-Trpnnrsr:nnrfin1fiEuo.r u:u r nofif,iltt 6 E t gl 6 o - t 6 - ia a U .s

01140\tflq1lfu:l ttill'luoNnn1\tlsU'lolvtu'l1uu:sd'rntEsu-\tfiltilusr'rrnufifiuuiuld[utq rrsl{-o 3a 6 v 6 I o '

a?rruflln'ruUa.r1:nfi60 n'ri riluv{rrlu olurilurunnrenuvrllrirfiqnnrrcfiu'r1Uri1:nsr'ufi:uu:,rgt6 s i - ioe a E E v 6v 6 6 v v

unu Ns t x{ nu u\t 1uu5s t ylflyrN0gttlnl:nq t d01r6ht unN09r5rn15 t Ro15nruB t 5{ 9tu6ht o1uoo

rutie-6ua-qr,a,Ja6@urs rnrllvtur^rufiurufirilurus ri.rfiufiasfrrn'ir:ru (6) c'rnn1:finurxu'irmnfiriluns rilsrutji^u:u xrrunil ufit nunoufi t quuo.r l't:'6tduo-n r f,u fi ( Hgsee ) fiua'n5rur,rnrsarirr firraovir

u o v a a ot - d d.- r ^ -_rz o d v . 6- - A . tlr:F|nuon l flu u Nol'urf,N?fligttns N6t1ui1u1unriytl'lr,t r noilc r i,,r ou rrstorqfrfqi-uduirMru?

( z , I , 9 ) odr.r t:finrruoufi r fiuvrrus fro-n:r r dut tunr: I froitnus r 6.r pTun,: n'irnufirri r fiuCopyright by Mahidol University

t

r,nucfi{ zzt fin trot rufrrraffifiorqrfiu. eo fl ornrtrinlunr{rfio Fibrosis rr6rsv

cimhosis naqrnnr:fiotilolt:'fln'uo-ntilu il6o g

ils tt{nuStituu

rs nnfrfifiq r f,ofidnn rdui eion'rr r fi n

eu:snr:n'mh nr:uri rtolrr'odufrnrnu fi qrnilr:qrirfiurnurtil{nrrnune

nnod (perinatat infecrion; ttuarn-urTu'irrfiunrrfroaoiirr,fiufiqn u#iifrlinqn!r rdu lutj:s tnsnnu uontufiolUQ'lll Parenteral routes [nE Sexual transmis-t-

sion fleXriur'ru'irfi{ouns e-s uolufttd#o.ttrid* Hepatitis B surface Anrigen

' (HBsAe) (r1) (or:',lfr g) u:smnriauac 40 ruEnrrufirfiunrurunsor?qru Hepatlris

e Antigen (HBeAe) d,rqsvrrr#Uo:fi rfronfilanlf, rdurdonr:fiqrf;omfu{ouns go.l g

qrnd'n:rnttfio{ouns e. t siofl finrrrfieursrlnr t.z flrunudofltuqturufi nrrne ,dc- o

72r000-108,,000 nu rnoqlfl$ilr,ltuurnus uncuTrrlru 30r000-40,000 nu nnrgtilu. a t ,8'.' i c. t-

$nucinnnllgroluounen6l0n mlnrun.luqs$10n'l6ll6t8\t ruut'nu8 [:01\tst't tfil'181'l{n'lu'!.

tilRrmrnnr{'or#o oonernirrn'rulfr fu ufirrwirr,ld,fiurnrseEfilonrnnr{nrf,atfr

r,llntfi usififiri*,r{ouac r-e doflrrirriu (rz) uac rfiufiuiluowirrn:nrraiirfiqr rfiuuraiir

uwinrs eru, f, r dnrAw,r.nfi rdfi nrr, r{ $Hua'r uqr uau rla.r riudfi u: s fi n6nrn

t


I

.jmllrln 3 Prevalence of HBsAg in pregnant Thai eronen

Investigator Lab. Method' No. Tested prevarence (z)

a

Chiewislp et al 1gZ4 IEOp, CF, RI 11625 5.7

Scott 1975 RIA 1,6Zb 7 ,0

Scott 1975 RIA 1,000 g.0

Bunyaratavej 1983 ? Sr4gT b.6

Wattanasri et aI

1986-1987 RPHA 10,342 6,E:

' IEOP

CF

RI

RIA

RPHA

I nnunoe lectro-osnophores i s

Conplement fixation

Rocket innunoelectrophoresis

Radioimmunoassay

Reversed passive henagglutination

dru rr,rqfinrrfie r#orr{afiudn reu fi rfio$uodr.rn{r{um{luu:s ryrprlnu fiatl'lt4s lfiuc'tu'tulilfiou ttns rfiuil'l rr4eil16'qu0rI:odufi:uur\trilsls r$ln-u nr:inurfrfirflunlas d,r tdfiurfirdarnd 6t-rNrinullurfrirrurd ,ffo riun'rltot frunr:fio r f;odo.r r fiufi.ronrr

^gt A. I d a d'114fl u flnul611 UUOF|G| [rRs n'lTAoxn6ult n i r ?r T'ht Ft1 fi "1 5 06| u l ffnr u ufin fi t nmm"r6'rpu o,r rlrgur

Itns fiuluu'tufiqs tfr'nfiufior n'unr:fio r $o1r:-tsl-uo-n r f,u fi 6.r fi r rJrr,rrurufiqu rri{nfluuri r 6n

u:ntfio rtastfinfiorusitn'ir r fi1nnu luuHurrurt{rrraiunfiftfiur:nrfiu5ru riutuuHu

frmnnrsr:ru4uurilu-rh afiufi z fl n.rt. zbgb rrilsu-.rrsifterrnnfirndrurfirururufinmr:t - | - '-'--'-

1tild:'ur-nfiu 6o naituonrn:n'l{nrsnnflti,rnroror:nnu fin1rrunnnnfin'ufruru rriutttt0d v I tt ula o g, al a u

tt$lvlu lltJ'lu'la vluattflilt tqruuryttao{duda: rirrarhfrsurnr:rion mr uaclundilfilll

alnnlifinurtvrrfiu:rngoreoufiilr rr,tsri'udu r rduri yrnfinri$n'ht rwoa'ufrrd fi,rfl.rrilfida6tv

n'r 5 fl nul n \t 5'1 u 6t r r 0 u o1u r i 0 t fi n'un ai ruun6t,ln 5 m1 \t n I : rr rm ftl

I


t

a

a

15,r flu-rulnnlrrwt r udt r fiuanruutn'llyn{ n.rrurmdtu:s dul:,r rqururnfrrlU

uo{ ntuvttx\t6lto'tstudu fiuonrn:nrtnr:uvrmfn'ir 300 Fru lursus z flfir^irumIt9.

stHU HBsAB'h'rfiirarnr:[nclrufiornr: ucirfi.rrtrfinrrfinurfi{Ftxlrudnl-l

-Era-At6.ud,uo.llxrtiloti'ttc5{e'{ tilo{ernnrtshfl specinens ai{ntrerilun156i1ufrx rRuiirurr,rr! nr^aq E- -r-2t ^ a d , (u o y jrfirJrurarfiut rrirdu"nni r Frx'rs l4r4"r6t'l r fio $ns riq,i'ufifuirua'ufiusnun1:ero I u0 r floa"r r fr]l

{ 1u1un"t51-l\t ttt^turtluaN ttas flo{ n-ulro o'uou u1lU{n1ro"l r fiunti [ffflW1]dEr:t snu

6l'ltua n11frnrrur:nu:cufrqvt:-nulnrei'l{ r ld ursnourYur-nfiufio{n-u1,:prsiua-nrdu fi uas

firuryfufnagfiu u-tfi:rorum E'rqf rfluffo{fter:ru'l1un,irn:u5fioodrr:slio:sr-r [ncriio

ndrrfitnrrl't\ttthturtluqrurraufiotn-ul:oorirt Iuru"ls6tru rfiorrflrdu:sfiylBnrwuauu:suf,o

fl:'flulniru'tndattiu nrrfinurfrau.tu,4ro oo.r rJee'r, r du.r sionr:fiq r #otr:'nduo-n r f,u fi 1uttl

unntnxls{ }tu1u''tilnltt}hr r }rdx 6r r fiurirrea"rfirglunr:1't{ r,.tur4'tnni6fi t rlma nru r fio r fru

uu?yn\r 1un'r5aluprrJuilr fiot n'unr:fio r #o unu uninre qru r f;oaoru

1. rfiofrnuro-n:rnrrfior#otr:'aduo-n.1ilu fl luunnrntuo\tli{tifu'tu1iln.ltr?l\t

iaoroJ,oSoz. rfrofrnurriqq.-urtu{Fronr:fisrrtotr:-nsr-uo'nrnu fi luunnrn:uorrl:tuururn

u - - ( aulnnu:3ilitnuo{n15'lqu

rfidT

A AO5lUXn51Un15'litu

io e'1. unnln:frfrisus t?ntnrrn'r.rlumu fitonrnfrorforr{aduo'nrnu fi n.rn.irIr,lo t rr

hrym5s uE t xn1n.):l,lht 1udun11o,a,.id.2u6do3--uuudra.2. unn'lnifr tnuilnrril=t'lfin rtosr frnrrfiqrfrotr:.anuoh rau f, a,rn4rfifitilrsrulrr{

auuAilnt56lNH6f t 61091

ia uA a.- v v d a Z - - u d r3. UFlilln:nilu5s?grqttnhulunuOnrilu Nn']5srotd01'tx6fnu0nrilu u 6litni"ltiloo

fifi r lifi u: s r'fi o rr Rriux u frua'n r fl u9lu0sJo a4, {frfrnn6nr:ilyt'ht r}trt'luil-nursuo't Multiple partners unr/u€o fi rnfi

a

f,irr{udn-ufifi r flul,nus z o't 15 o qs r du r sronr: fi o r #otr r-a6'uo'n r ou fi t,rUg


?

rfi g tu u ffi nrn'ir*'ld:-u

1 . t fiurur nrr lunltnluuour^tuit'lu uas nai6tunr:nrunuflor riul:n1r:'an'u

a-n tdu fi 'tuunarntlt.tnururn

dU

a

ooonrflu u

nle'n'nn?,ll

-i

6-C-uz . r iluu:s lutritunr:ffon:?Euna''rni finrrqs 1fr:-u{nfiuflo,r fiultfnsiuo'n r ou

3. rfrunrrtatrun{r,r u{rg n'n-rlq udunarn:1u1t{mf'tu'1il

4 , r fiur?ogaa'rra:-unr:i{u r fiurn-uJ:c fryr6nrnaor r-nfiu1r{dsr'uo-n r ilu flfiqgn'rrfiunrrsiotu

s . r fiunr:nre #mriunnrn:tdn:c Hfn{1unr:oruarunr:uninru qru r f; orr{aoTuttt

a'Eaolnrlnr ururuil.r uoonfiotituorfivrd'rdaruil 6o nfinrrun'm?1il6tso'lo nTnlruttoert- .t -- t a t ra a C u U i- a C U a itld'lulunonulu 1q-ll4u.tyttvtouonttltflvru rerulnhf,tdrrttyttl tqruurytrulutn y{u.tu1ag

tnnfin mlrurniurflvr unnri n-ususmf n'usrrurris {drurTuoumti nnrgonasr'.rndrr ufirihrtt ruaeitur,rilru,r ru6"r fi60

It

1. rrr^runftJruuono

z, trnuninutg. alrufruon::ru

4. ,.i'rulRdurn'll

s . riru r rdn::ru#r nru

o. uruunt-tfi

7, uuru{runnr,t

B. I:rfnflon

9. uilru{rut"usfnrttnsDulorr rf,on!

U610. t 0'l UFtlYlU'lU"lRltRs An t AU

-ttttrq

11 . 140{ 3^l'l9lo

aCopyright by Mahidol University

ir

I

U)12. [rHUnr{UXUlU

T

da- nnl{rflua€- onshr?l

dannil'lt | 1dn55&ttdAd- oniln-utrldnl5r

o4o- onolulnSlN[nsflnun5:std'l?, 1

I.t9q- nnflnunstild1u 2

- 6norqrnr:mrnsdaun::ruufrrI

oXn.l:Bnttalt:-fln'rm-nrdu fi uil'rufi\t nl5at?4tfrjitnulnu0{ Hepatitis B

surface Antigen (llnsag;, Antibody Hepatitis B surface (lnti-Hus),

Antibody Hepatitis B core (Rnti-Hsc) ufrofsrtfiorfu r,liomnn'irrafr,rufio

oTsnrnr:finrf;olrr-tdu q'u'rurJnnln:fifrorf;olrr-nsiua'nrou fi

qTnuunaln: fi r r?r{ru.lunr:fi nur

ffrq-r,rfiu.r umufir fr,rfivrrrrfrrfiqnr:Hsrf,orrindua-nrilu fl r,r$od,rfifierrr

n-rufiudn'unr:fr o r #ol r :'ofiuo-n r du fi

Multiple partners ururufir nr:fiE"uruda-rufiudvnr n'rplr'rnn,i'r 1 Frus

aAinil! Uulun{ Un0nytstl'lEfiU HBsAgt

ooaA6A0t6ua,n15fll|il6llAAn Uil1un{ nlTNtROnnnEtO,tnfUU\t tUrnr tlnsU-ln

x 100uaaonldu u

a

rCopyright by Mahidol University

t

' -fi z

d A- A ; a'l::nnn uas{'lu'tilun I nulto{

lr:"afrudntAu fi (Hepatitis B virus, HBV) (lg)

Sd.s.oJEoJaslUO HBV luu DNA virus a0Og1ulll{N5l Hepadnaviridae tUolultflNiltou'lnu

!'

{lrfruri rf;ofr{nfivrrrrirfion'u0-nroulufin{unc rnndrdu (wood chuck), nisionu'lil

o6stduq. lueul{fluE tt6tsit

lc

nn6lxunu0\! HBv

a

r. rT {afifidruu:snouf,Nurfi (virion) fi:un:rnau uu'lnr#uri'loutfnnrr 42 nn!-'tto

2. U:En8UdrurUfionuofl (outer capsid) [nB$nuR'lU1lr (inner core)

e. filwrfiu nttta 6t'rug, uqrfiur{nil, riturintulilqn 1.6 #ru - 4.0 dru60

DNA U0{ HBV NRnUn&fr rouSir{qrn'l',riaiU 6o unruu'rorfron'roRau + u'ln'lu 15-b0zdaa

$nsitsFnltdautniilonont'lnt Iou rouf,url DNA porynerase fiadrr:tununnr.tt6a(ra4, lllSUdUf, DNA pol5rnerase, proteinkinase $nsnl0?'lN reverse

transcriptase olj1u virion5. DNA u0\i1?:-6tirsilrun'? (integrate) n'u1nr1[1druUo{ tdil$o'uiifiorffouoq

6. fl-nunsuo,r r#arr{arioofrrunio{ennirod vru'td a urlu ruurinrfiu:unr.r!t

iatttr€J,nniluu'to 20 nm rtuuyr6l0it ttjuSutlvl{t5luil'l6uunn1{5'l'l 20 nn rtilEu'l1nrllto 50 nno!

olrd6teufr''t 230 nn rt5rsttuufinril :Uir\innr uu'ro 42 nn tfiutfimaru"u unuRlulu?Ju"to 27 nm

od.de

t 0U I TUn11 Dane part icle t,l t Utl-uvirion do\t HBV uulo\t drunotuuu[:nrfiu

ru:6ufi4{r,rmrflutuf,onuon rsifiqlurwlnndrununlulu i{mJoritu:uda:s o'.mRo.ttu

Host

.J:Ufi 1E-_ Copyright by Mahidol University

10

t

t

J

ta-6varttaolull 1. AnfflBUO{ hepatitis B virus tlI0SmUnA0{eAffi:6UOt0nnlAuutnnilB-|ut-tl

252,000 lri'l

z. roufireufidlo'rgtot HBv fi g ufiofio

7.1 Hepatitis B surface antigen (HBsAg) ttu0d'lutu60nuanuo{

virion tlslsuu particles vl:itnnNilulqtfrnn'u:Untit o:rerrufdfu6{rufuflr:6eu#,rg

air.r r ttns1ut'u1nnardru?Jo\trtnjsriu rfruuoufireufifiuiurnallnn'i'lrraufirquufiodu rct - utt v A d

nls9lil1l45-l{nlu6l5'lil anti-HBs fl\t tUU protective antibodyI

HBsAg fitftfin'nurucuoufi rqutiouruneiolufin fi0fi a rfluuaufrrqufiyruirl uflr,C-aao,'-'

runetorflu z 5suu6o d uio y n1u w vrSo r arnn'nufrsraufirEurioufi yrttfrrrun ABsAgdad

oOnlflil 4 subtypes 60 adw, ayw, adr tt6tu .y" fitqsrturirtfiulunfrnrnsrr.r 1uo\tn

tI,nn luuxs ryrrtlnuyfl aar rf,udrutrar!


11

a

a

7,2 Hepatitis B core antigen (ttgcae) ruaqifirrnunilr.l HBcAg fl'- o

-uio at - Cv o --. - a o ,o J Ioi'lemJlnnu'rlnau6lu0{rdonnu un'lNfiu HBcAg lurnanrffilcri HBsAEI nilrauonduul{

.V UuolrTrtfrAr: detergent n'lnlu HBsAg qsnllinlu HBcAg tfr Hgcng nrs#ulriirtnru

aARirr Anti-HBc futinrur:n{rfi'ur:nrd udrfiudrarn'rplunr:nrudu cyrotoxic

T-cetl lrtvr'rnruldn{fifiq,$o ,irnr.nfiu-{n:cfiu helper-T-cetl nt'l#n{r'rrouhuafift aato0 HBsAB laquu

-6, 1-67.3 Hepatitis B e antigen (HBeAg) luu6l?uu5iln0uu0\t HBeAg 7l

douodnrururns flnlufrlns n"ru0onm1ufi:-u1uf, n:ltru0\t rt0ufi r eu6a:s olqtlu r n'ts 0dn-u

f,

oHBe

{

a.t

g

6uotbIgG raioo;agfru nl:a:litnu HBeAg esiltuon'irtufi:-triufi virion-{uirrrrq,r frrn:refiu HBsAg usirrinu HBeAg uilgr,r'i1lufiilr,riufi virion

uoifrrnu Anti-HBe firi.rfi.r'irrrifinr:n{rrununin{ua{rr{nu#T fi:truiir,u HBsAg raa

HBeAg 6.r fi tonrsuyri r $o: da.r uau y{urn i rild'i rffieu ut n.r fr a r $o r {o:-r d nur u

mr{fl{1{[nsrr0ufilqudfiooi1.t 'l uo,r HBv o-'r;ufi z

o

IIBcAg ldanununmly

Ag ldanrrnunm.rmuluy

ttL6.1n1{61:-l't]lacllOuntludunR'l{ 1 uo,t HBv

ldrufiaron;

I

uo\t HBv 0d1uo

rLtUO{ HBV AUUOU

g

'lJn 2


L2

a

t

8. o1'l$ytun1uu0\r,f,0 ,ru flnyt'nluIounrrru{ou 100 o d f urfi, u{o

60 od tt1u 1 drrllr, 'luslRrnnio pH 2,4 talrr e urrrl.r,f;oorulo, tilur sodiun

hypochlorite 0.52 vt"l6t'lu,$016, dnnaaaf zoz, no{trfru orur:n?t-}5t'lur#orfi ufi

'irr#o HBv qunlu ud ugslg fi.rn.rfinnnrurihrfiuuoufirautd ,#o 11ru linnr'nrulEru

:\fi

9. 1un1l$un;iruu:cnouuo{ rfianffruifi Cohn ethanol fractionation fiu

'ir unv o{ru fraction I (fibrinogen, factor vIII) trio fraction III(prothronbin conplex) ttgitamsdril HBsAg csn{fluldlu fraction II (ganna

globulin) rtna fraction IV (plasna protein)

rurleliurf,onfiu'uruun;iT urdairunlieri're HBsAg mu#r rnc1#ranrc

lftfio Hgv ilurd'lurf,os 'luf,r:sr-oun-rdtr "l a:'leflu HBsAg td rreieuy{u HBv ld

J

E

ra,d d --t . u

ln0OYlO5'lQ'lNl{u HBsAg lVt'luu

aa60n.nnnno uns ru16n't I llc

e"ulur?ouunr{u'lun:ffifiriaouuoonm nt:6osio6,rfiordvrrrnr:trirfion Hfinfirufrqrn/tCd

tfroe tilNfrour nr:a'rufiarn#fi0 rvro#rur1u$ unufiarfiffiaodo nr:6orioqrnmror;inr:n

(vertical transnission) fuqsfitanrnfrostordrrnlu:susnaan$ac6neial61u:sacE-uttu'tg :sus$lnnl 14-lB0 'r-u m:doaluisuu z-g tdau

nrr6orf,o HBv'tunr:n1riu6to\rolnrilie rrsinrrnqcnnrurflunrurr{or'.r

al?Emr HBsAg rd#turiaru g-o rdau rnsodururfiufl unir$orriaiodrnflEerd tur6n

:nr,rio{rrar!fi r fiu,r dT uriouduaoo o.nr:r:n6'udn r au

r f,olr:-a rflrrurfrile'urulusr-u 1u:cue r frrrfio r $oqsfinr: rf,uq.uruuo.r.l.r:-il

illn (replicative phase) n:rastuldne{ HBsAg, HBeAg .lurfion .lu:cusoiorurnr:

fll"t{Qenoa.r ririr.rnrullicrilr:nn$orf;ooontrl'tdr,tun fiu$rorlrr'o (DNA) ,r,fa


t3

a

trtmud, fiu DNA uo{tdn{n"u (integrative phase)

fiour risil HBeAs

finr:a{r,r HBsAg'luililrn

nr: r fionurBanrn r ffrtq'ir r frunnq'rnnlrd , miuot :c uu6uu'lunlnru r tnffifi

a

muhteuua.rtr{a ahrrrpilurBf,nrnuorR-unu'irfin;lruo.r rta{frufi,*ou (a"eeneration)

ItSlsR'lU mJ reticuloendothelial (Kupffer) cell rfiruqtru ffi.f periportal

inf iltration 6lu nononuclear cel1 frnvruudoutuafEtru rir reticulun

framework uotdu'tinnfl*tnlu r un5fruqrnn-untr,rrirfitdtu g-tz flue'lri ru{rrarllifiora

rfiu +O fl arnr:linruoro rfiq fib"osis lrils cirrhosis ruanr:fie rf;o ttru qsnTfietd to. d , o 6 - I

t^ro$l t d0N0n:-l 16lu{ n0n'l: t nous I tit au6lit DuIt

Hnn1ilil'run-{rrnnr:finr#o rru d,rrrrerlu:ufi g

f

a6 o-oI

u!.luRuuSln{ Haf,.lrrnHa't lnnnn I do HBvI

rpcrfirravuuu&urffirAcntcHBV infetion

loang go nrsrlattaa9070 rcsolution

ornrrm rnfirin fiuinrs ur6o ulrClidcal : Acutc hepatitis B

Ae rflalnalriucolarnn$rbclinical infcctlon

loue t orrmlrurliudf?ol7o fulminant infection

Pcrsistcnf infction(HBs Ag + ve, anti-HBc + ve)

fir {e llgv o an nrnrmrslfin rnComplctc clearancc of HBV

fludnrEUl70r-rChronic hepadtjs

trn:tiuenlornrrAsymptomatic carricr

dfuo-n r s uriof.r!fi n or nrr sn ar uChronic active hepadiis

ihtn HBseglfriarSpontaocous clearaace

ofHBsAg* vc, anti-HBc + ve)

rcrf of,uPrimary hcpaoccllular carcinoma

f

iun 3


t4

o

nr:n:rcruuaufireuuaouaufiuafiftiafinrilo HBv (serotogical rarkers in HBV

infections)-! U r,

fu(fifiorfio Hgv tlso5lEtru viral DNA polynerase ttas HBsAg si{[ritursusT

f,noh tuoufir'tufifior#o HBv aunmanr HBsAs rdriluru frro:retru HBsAg ururfiu

e

I

e rdau q'otfiunrus,{o:-.r (chronic cami.er) 1u:uusdorleflu HBsAg f,uaorurr*.t)-ll-

HBeAg 51N91'lU Un{q'lnuutN0 HBsAg nCTceUn{ HBeAg Stsu'tulu

uoufiuofitfsr'rutndrttefiu 6o n'ti-Hs" rrutduo-rfiorf;orur6oud z-g ftfiurfioou'tflfiornrrfulinni?EmJ Anti-nBc r#r lu:sus$inEserrleyfl Anti-HBc Igu do

N'lr{u Anri-HBc Igc $ruodldururfrufl un',rernfi HBeAg u'tulurfit r-z f,uorri qsfigt6.a..uej

Anti-HBe UslnAUu ttnsOuu'luluui]tdunu ii'lu Anti-HBs euen'rErulut-lxr6oufr e-Oqdty-4rda

I'ln\tAlnyl HBsAg Uejqlualn t5l0O tlnsAUmUtilUil!

tufrfin:refiu HBsAs, flrrr\ urntu r 6oofu uonrri'tf ir r fr,r finr:fio r $o u5o r fiu

ynus t{a:',l nltgti?ev,nl:so'uuo.t Anti-HBc IcM qsd?uuontd tu:rufi rfi,r6orf;o ery{u

Anti-HBc rglt luiso'u6t.t udrirrfiuvnuct{o:-turururrcnri Anti-HBc tgtrt 1u:urr-uoi'r

ai Y ., , ! sfifin:rqnufr't HBsAB tt6ts HBeAB esuonld'i'rotiturgusfirf;ol'r:'cfinr:url,rfrr

.i-._-_.__. p. _ ___._-!_ , 4 ,-ri u d o ItfrNa'Mltl fi Dane particle rl'u1uru1n nrrur:nhodourirfio{{duuasEuu'{finrrdorilot aA - ar. ,, Dt 6

OUU'IU {yl051enu HBsAg [t6ls Anti-HBe esU0fl1011n156l5'lrl nucleocapsid lAUAn.l9llr.et- e .. rd . X- - ..,ui dD @ilfr? i.rrufr HBeAg oonl'l lonrtfiquuvrirtarurifituecFfioa rrasqumJ:cd'u HssegNT

anen{ t50u 'l

9.12uo\riururififisrflo Hsv 1u:sucu#{finrfo 1-o r6oun:n o.tqatlqnu

0.ddrqaf;rail

Anti-HBc OU'l{ t9lU? l:Unl1 core-window }lfl.lQ'lflnnld0lt6l'l 4-6 t9l0U qUnSlaHuyhl

Rnti-ngc tl6ts Anti-HBs u6rsHuururfiufi o'rqnnaofiin rirrfiuyrruseul.tu HBsag {tru{n-u Anti-HBc o-,tlu:Ufi 4Copyright by Mahidol University

t5

a

ll&Ag H&Ag (rnti-Hgc; Anri.H& And-HB! lanri.HBcl

r sus rlo fr ! s rf, ,rtu$*I air *''"o fo o-'rr"

23

==a

€l)

tat

t orISGIPT (ALII

ornlt

5I

t It U0.l U:s dln:-u 6A6l1UnU Nrl

o

i o a aC a. o o o cr.lll 4 n15a:1lliluuounliluuasuounuonululflhultnl15flnuanIdu u

ASstnn'lnu'l

rfrorritsr'udnrnu fl nutdnnniinrnluinn u:curilfiu'ir{aunc b

tnn rlioursu-rru 200 #runurflunrusuo{Irnfi tunr,rriarrinrrunl 1.5

1

7

tuurnlrsulsltlfifiouns 0. 2 nu'i r fi nr r u d n il{ luu'l,r n ri r rdnri uFlil''r n 5 yr-l'r nr: u rrnf{a u nttgri

ru{rJruflrttfl{ouas s niirut:nrf,ao h"rophiriaci {ounc z n;iufinurrilHfrq:'auilcot-l, o- E o d v . u r a ,

naNil1'I0 tlrtnutd0d"tsrr0rdu:Ouilc 10 trflunnNdlutnslNlytflsDuilc 6 (r4)tl

1uo-lnrlu (ts) fio'n:rnrrruneit fiu:cdrn: 1 'lu 1,000 Fru rrirusufirfiu.V

vnfis ndrufinurflo sgv f,.r1uo'tnnu 6a nduurur-nirrurnfl flql-urfiu,rriarn'rg tduri nr:tot.duu€9

illfl aunl\t t ?$l n1: I I fl Fl5lImJ6', r41{ vl1'l: run

luuisrytrttyru (13) y{ui-tr{aunc s-ro turi'r.rotq 10-go fl qcHuarnirdr,rlu

i , :8 i ', a0"tU0U 5l'lu Anti-HBs lIUtttllflugl'IilO'lU 1sutaaUnulttu:ctucts 41 ll Anti-HBs


16

a

a ' d u:slfldltnufifinruunro,tn'l:nonoill,til'luyt'l\t u:s [ltfl[tnunNnl-tN, HBv {\r tfruri Urc rvrflrnu

6a 4t .t tHnrt'lu'lqun I nu:l!0\t

C

J

rnsnl:ld{urf,oor,rioarfisrfiffio.r rfioo ( 19)6 €t u

HBv fiounyrddrsrlo ({ouns 2z) rns

I{illians ttduFtnE (241 tddnur:su-toivru"ru0't HBv 'luuFril-tn5f:{}ru'lu'latdJog"

?rul'rru z9 r'luvrerordo HBv 94 i-lurfiErtur{rrarirfifivrr,rrutur,triru#r.rrn 6n 84 luvt*t{ "tu1ur40{ U0uanlt

l| a6 .i o I q o (o vt . v Ae'ux uyl r nquu6lNlruDnu4ux ulul,ru?un1{ lFr nfluat6tulnuort HBsAg

o

a'n:t1qrui'uuotfruo-nt6lu rrnso-eri'rn'l-lruqnuo\r Antibody rin, ru#uvr'udfiuorrutduqqrnI

a u 6 a 'tt t D ^ra I

n15druhlil r fiao qrnriululrnla n-t fioqiluuruununs frol ilfififinr: r toirfinr:fineiorouqrifi r r,ln$ l| - ia 'r

r 0 r fiu r'r€oflrtinr nu'irnrr6noioqrnuri'tufi.r qn r fiunr:froroiafin"rfrq ( 19, 14 ) ruara{go r Nin'rq i d a . --tt@ A A o q d lt

$iluu5s tllFlgtu'luonou 1 y{uun'l59r0rgr0yt'l{n'lt'lolurn09 ffiaHnnnffmlnr5l0o 10u[1i^l5l

nndnorrufilufiiqrnnr:nn r fiu,rioounrrfifiuuo r fiou nr:n-rufiarn#fisr nr:fi r nfid-rufiuf ruoqq @ . E.,et , gtlqq;ur,tfr.rfrilforunu'rt'ir 1 1u g ({ouns 93) l{u1unairu:-nirrurwrt rrfls 1 1u 4 ({ouas

25 ) stulun4u*na'lt rnfl ( 14,16 )

tuar,ti5o r rui nrfi unru :lu,rlu6ua-udriudqunr:fi o r f, atr if, sr-uo'n r du fl ( u"pr-

titis B virus, HBv) luuna-ln:l5.rfiururnunruud{ nurToiurdu.rfififonrafior#oiauo6'

HBv N1nfiilo6o nr:d-ltru-f,rfion (12,18,19) usiur',ruri.rfifinmildnuoir1xrtsitrfiur{ouns 4l--traY

nu'irnr:6nrto Hsv trifinrrilrsrnsir,rrYuturlq{'unr:#rurinrf,on (20) fifrfinurnu'irnrirudJa. o I v a | . e@ - i

unnlnSn'litn15l$tyluvrNo9r51n'l5Ftold0 HBv t0uas 16 Nnxlilttnnnf it0u'l\tNuu6l-lFt[l|ttjoI

t u{uu r fiuun-uhiiruorflniirru r du,r sionrrfio r f;o HBv o-en1nr:60 r #o HBv uu5r.r-ua'rilu:s 1tIoI

n'lsAatfiomnou qfuruflfivrt'r"l1l ilnso'lu (19) tleilE-lnnr:finrr1iluli'lUilntfruwu'jr nr:o & -.d ot v (s 3-o ' A y0lor?f0 HBv 1ilil41'lilf,Nv{u6nu0"ru ttns1]tF{ (21 ,22, uonqlnu[{sinulflui']nl1aord0 HBv

luuonrnsfidrurfiurfo.rn-unr:o'rrt-uodrufififiu:sd"rn:uu-luilu unsnrrflifinn-u#rjrufirflur:n

r,tiotflurnr,rs ttsiur,{rru{ru}u'i1nr:fiorf;o HBv lriuuTfiunrtnr:il-rufinn-ufiu'rs qluruflfig

A-dd@ad6n u'l1u6l'l?J "r0'ld $r n'15 Nut u'l etgn r u ilet"t

u't{ l"ru\t'luynl'irunnrn:fi r du.r stonr:fio r froI

aCt'tu'1fiil1{ytu (23)

a

uas 1ruU:rnAurif,o'irfinr:6q r f,oflr{ t,tfloo r f,os qrn,ft.Jrut:ntErd r fiunru,


L7

I

vadddtewis uas008 (25) loflnul1U:uutvluual"tNnu0rt HBsAg ttsls Antibody

I

lundruunnrnilul:\tmJ1u'rn $nsn;iruonl:.mrulu1n loufin;iluonll{v{?J'lu'rntfiun;irunrunruttrrlt

firdfunr'a{rJru$ncHfinfisutrfiosr nuirtrifiorursrnpirttotar'lud Hg"ag 1un;iulr{ftururn

unu na!uoruqu odr,r t:frsrril HBsAs fifisrrrrua'rufrudrTurtrr rGnr:rdr'u r f,on1un;!runrunrutttt

usirilfi m rru#rufiudrundrulr,r nu rurn u: s rGnr: r6{u Hsv lilfi nrrdrufrudn'unl: a:1 EmJt'

HBsAg tunriruvr'.rno.r rrd antibody firrnrfiu e rrirtundrlr{nuruln #rrirfiu'irfinr:

tdu.rsionr:#ufiR Hgsag uonr.nfi Antibody u-rfirrmru#rufiudriuu:srhnrrrfiusr-uo'nrdu

'luunnrnxlr{$rulu1n udrilirnmrua-ruftidruna!ilnxuqru uasfi'rrfrdafioddrnmudooo ns"Rgttt

rrirdr fro#uat lun;iruunn1nln1it nrr unnti udtdarm:naoutf i'rn.'lu , dun oor nrrdruvroo r f;aottv A .u,. ; Y

HBv orn{gun4unrnfrwuruaulnu0{ HBsAs {{rJrufignguoriurfiuodrrlr

snith $nsane (26) lfrfinulanNtf,utEronr:6g rfio HBv luunnlnln1{nliI

d s q a d I Co v Ittv{vru ssouxd'rd}r loufnu'llunsrilrrnvrunununrrnyru lrlu?u 174 au lrns 125 au

ttv

a1iln"rffu furiurr:nrd6nulo'l"rlqnu0rr HBsAg rlfls Anti-HBs ua,rniiruunnrn:ir',tf,o{n6irtl-ttt

-dctvrtUsuun4uununilNUrsdrtuvr'rtU egO nu mfirn;iru[wyrriunsyiuouyrvrtifinrrrudnuornr:60trt,#o rtru q.rn'irnr!ruu:suruufi'rtufi,r 3-b rvir unsfioruusrnEirrodrrfiriunrn'rpvrr.rcfiB

litnunlrrunrrfinunr:ru unufffifiUrc{6#un-a HBv esnu sero HBV 6-rn'ir{firilfiursr?unndr{rTuorir.rfiriuarn'Evrloona ( p < 0. 001 )

aa 6s u u v v a I u tt iGrady (27) 1O6nUl0NqNnU1',t55lOU0nrdU U lunnilte',rllu'1v11:{fiu'ru"ro-stt

i-.ttAet.-ouuv@ur fia ojoo: r eurnair r rirunufi qs td:.uTlofi urio.r nlurT :-aniudn r nu fi e1nelu'l u 1, g zo ou

Ie t 2t@ Y

r{u Anti-HBs 229 au ({ounu zo.4l tueturufifi 764 Ftu fiufirasnr:fironrnr6:'urtovA6Eau

HBV mJ tlL oU (:SURE 23.1) nU Anti-HBc [r5rc^410 Anti-HBsrr{ 47 AU (tounsio . a a . d

6. 3 ) YIN Anti-HBs Ou"hl t 9lu'l ltns 27 nu (rOUas 3. 6 ) ]IU Anti-HBc OU'ltl | 0U'l. a 9t tu d q v ( a da r . V

v{lj'l-la1lildnu0{ RNoNnuHnrrrudrunilfi0u1{ il1nnun1ru5n'r5yrl,t nilun I du l4u'lud"ht 191totu

trruunflauntlN

t

aa

(p < 0.001) rfiofinurfi.r:uo-urd:u5frq Toufinurralnen{ufifireffuro:u5frenirffu runtt

N'rnfiua'rruo-ru u6rs rfiofinrrtl

(u(ta)-a)*'tawrslunaiutt$rildttnsyruattylyru fiu?'lr,n4yr-n4u'ryryr'r\rFr6run::N fittu?rrilfiru Hev drn'ir?ifitsgs

t


18

I

t

v dva i r 6 v v v o . d dluo{nnu (28) u^rflnu.luFt6rlnlnu'lutuul'lt6lnu0nlilu u 51 r1U mJ?lNrm'\t'ot,lio 6 ttu X a ; A d 615 5'rU lvnuuvruuS8l0nl:105urd019ru9n{ r 3 5'ru}rtnoe"tnn'l5Nu'10tlilnQ1nn1:oo

o6lFluU

^ I ( d r ' Aialuuoirui (29) finurtunriruod'rnid'lirtrfi fimqrnfiufifiomuunuo{ HBv Ft{

66etADta:1atilooflutfru.t5osns s fitrir^rnurn sulurr{rtd'lud\tn'i'lrflfluft{ ({ouns z nas{oane,t

4.4 gt'l$nlo"u) ililnr:finurlilrunmulanfil{ lun.ilfi #rria r f, ooor uns n;irufi flrufrn r f, osrsiraad- r 4 al. - v az{ tlnnn1{ e"rnn'llflnulylht-tuil'l trns 1u6lur50 I $5n'l

luAitou (30) vt'l Follow up study uon-lnslursusl'16r'l fS fl fourru.rfio6l

el'lNlilu e rir.r 1nc 5 fl nrrirvrn 5 fi nttack rate HBv ;rgr6hrn'lunldu 6a 102.0,

30.4 [ns 10.4 per 100,000'n"""on-rears unsfitfiut s :rudnulullri, Ufirfiu.rsio.g6ai

nlselotdo HBv 6hr n0 uurulerrvruu d'rfiIonlf,f,{riflrf,oonr odr{trfiorl nt5frnu-lnoo d aa - 2 -,

n

lsuE [1n'lu-l'lu'luuuo rf,urunrrifiedu rfio{ernnrr rUf,uffiUil.rturnnfini6nr:n:rq

Marke r vrr.r rio,r Ufi r3hn15 luri x { nr: 6nur

'tutuo:fruns1-unn Janzen ttduona (g1) finrr:curqinuruort HBsAg $as

Anti-HBsAg lugonrn:li,tt{u-lu1n eluxu gr77o au nt'lEr,r'l1oui6 naaioinnuno--l

assay (RIA) nu'irfimrrunuo{ HBsAg rqfia{ouns z.z lrds Anri-HBs {aunc !!,7daXfrnrrfforfiont1u g orfin rduri unyrf ({ouns 18.2) t.ru'ru'ln ({ouas 20.1) rnr

rnint runlsri",uor r"', 1{ounu 26 , s) r iofinur r rliuu r fiuuflun;irnruEru nu'irn;iruflu'lur6ldri--olllfrnrrrunnnnr{fr:so.'uft,d1o-ru (p < 0.01) altNilnuoit HBv (HBslg, Anti-HBs)

finnrruf,rufiudatn'ur{rurirfirnrfial ({ouaa 31.s), tfruf, 1{ounu 81.0), {nu 1{ounu

zg.4), finun::rilis6t'lyt 1{ounu zB.0) uncflaun::ut'.ru ({ounc 24,41 'lullt^tunat

n'nun::rutt'rlunu'irfinrrrunnndrtfi:uo'uriuarir'rg rfioruiaurfiuun-undtnrupnr ({ouas

14.3) rrnsu-'rflu'ir{fieunfirlrusr'udnrnufio-n:rnr:finr#ail\trnnei"t{firsdufiunr6rU (p.0.05 )

J

iCopyright by Mahidol University

19

t

1uU:s rnntvrurirrfi fi nr: fi nurir ufiuo,r dnr:ourriu lnn'luusstlrFllvruux{u n.Fl, 25lT-2518 runr:rlnut:tunuolRlntsou'luulilndAY6nu1n1:etotuo HBv 1uaulflu uu.rrfiun;iuU:surn:r['l1U1drui finfinurrrwrfno.rfiAoffru

. .. -.--------r € eta v v . - i -o d 6 6 Xunn'ln5n.l{nl:tlv'lYlu l^lo0{u{?ut4ulJ tr6troudt'lu'l{[n 1N0lu5uutytuu0[9tn1tn1x60td0lgtl

' g . d od C o ! uHBv'lun6!$frrirec6qrto$"rnn'i'r 6o finfinur$y{yrd mJn'l:norfio Hsv iouns 49, uanlnit't

t

tl 0t

il'u:"unrr 6nu11uueR-lni 1:\t t{u'lur n fi i : rudA o -E a ofoulnll 15-ru?on $ils laNdu

I

a luuu?'6 (s+) lduurniirunr:finurrfru e n;il6o n;irufifironrnfiqr#onrnn'ir (Exposure-t€'ltgroup) tdu uuytti Hulu'rfl [nsntiilfililfironroBorilo (Non Exposure group) ru'irfi

IA - . 2t q a -- .d t Ea

HBsAg iounc 3.15 'runflilu:n u6rs:ouns 4.82 lundlr,tfr.r flrrdfinllrurtnnei'rrfifrnrrn

ardrpnr.rafifi unsldfinurrun;iufin6nu'uu{yru uncunstnulyru'ru1n mlirffrn:reloui6

Conbined-immunoele"t"opni""sis (CIEP) fiu HBsAg {oan, 4.5 [ns 3.6 B-lN

il*to'u rafiurfiuiouns g.88 rrsirirrflifi Radioinnunoassay (RIA) fiu{ouns g.gs

oa C

u 0{ unFlnul tll,rfi u r[6ts y{?J-luln

'loot{ n\l :'tu{ lun'll t sluu'l u il 0 \t unnln: 1:.t y{?J']u1n

:rur6ud tsvl'itlfl n.fl. zlLg-zszt vru'irfinr:rirsdrutrn6'udnrtuu:emruflas zo

:ru 4,rtue1uruf,ur,t:'ruo'lerfiurfinro u'r{r'rurfiwfinfi urifiriraurE6a unvrtifirixulau

6t

a

li{nuturn ru{ouoe 86, unnln:'tunfifinn'uanr5N {ounc s4, fi6otu-,ti'urauru {ouns

80'80, auu:'lxouns 62 SN0ruxuulytuununnNglo ,- u u . ac., u u . ia o .3uu 6ttnru u n I 1 ufl nilltao'it u it 1 ut4uNytNn't5ao I d0-t||t

uauu:'lx0uns r io r rtiuu r fiuun-undrunufirruru{u r 6arn'utrinunxlil$airdrr.r odr'r fi

I

d

r o a 6 i,HBV Nlnn?'lUOreU Elnn'r16nu1 rUUyrU-l

U.d't tnn'irofihn'linlrhotfiotun;iruorfivrfivrr.rrurulr{y{u1urn fironrndufiorf,on unsrufintls € d -.- . ' i ^

g i . - arirufrern t fiootdnr n'irmirnj:s urninirlu r fior qrnnr:fin r f,oftnurriuo'lulurhu r :r nrrrul

6nr#o;irurrar!r rfrrflour raionrrtfrf,oo (ez)

innn-l:6nb'lsa{ {uvrur n$rDun (gg) c'lnf,nrriuie'ufr:"d nu'itun6r'rn5n1irI

( o a .t ' er i ' EEnllurwrti mJhnu'rnuo{[ou6reudfrofi 1nu"ae) lioufiasrfuiriouac z.g 1uflrwfinnruardorto

Asrij'.c.Ed^ttu'llflnfianud{dqiouns 7 .g fi.r rfro'irtunairunnrn:nt{nli[]ryrurun'lua{NRunun-u1:n

$!

fio5lua1r

aufind liiriraur (ss)at a

. 4 d4 a a ( -tt 6, u . A a . ,'urnttuttttvtrifrnr,th utouvrvrdu:se.ttjru riluun-{ernlur.irurrr,lunn6-uirxu il1uoufinq rf


20

t

fro6of irorq r fiururd'i1n'rifl'rpriloo#ufironra#rrlinfiu r f;oo$ln r6rs u-,o rrir-l.tdn,r irorriu et A a o q q ia a o c tt 6 , 'rg

.nu N10n"rflvr r 610o6lrlr'r6lnuu'loililnY|sro 1450 tnoQ'lnnl5 t uutlt^lnt]n1$nNo 0'lc11ultnnuuultJ

r . c u q ,- i d -- --ttt d 6D b a Dnu'iliru r ilulroeTudn r nudoun'irunalnidu o'lq r fiututddrfi1fi{rurtu dru r drr,rfirf4finu

rfrulrno'uo'nrdu6hrdo 6o nrndvrrrarirdret rfioo u., ,fiuiiillfl,r rnsrirfirhuru-nrfiuia

Uaa'lnlvrru'rru'lvr-r{1u1r4ri uonqrfifififinu1fi{11i-6lsr'uo-nrRuufio fi rfiuriun Dena'rqlantigen finu tou Rizzelto 1ufl n.d. 192? qlnAorrfiru{rJT umnfioutrilfifro (36)Aad\t tuu incomplete virus do,rrrfl HBsAg mirrudru 6o.r,irrrfl,fiorrord rinn.tlt,1rfiel

I01n1:l:Orr-Udn t nuodrt Tulrs{ ( fulninat ion hepat i t is )

( gz ) tdfinu'llqunrr r als r fioofiurufifi r ffotrr-nfi #u r*,rr ,oo

add6(

0-ldHylt{uNrna0 [tHytu

11 it ytu 1u'r n dNvtS u5'l n1 5I

fi,r{oune b0 unsnl#{ rfiunrur {ouas 3 ;irumnnulufrnltrurululurnsnnnnf,rTut'?rirumnItto

v{tJ'lu'ln rrns ynint rurfro t d-udsr: 1: n rrsinr: fr nu1'luuna'ln:9tl

lou rnn'ur Indslsruad trnunrw (39) ilu'i-ltdfinrrrurrsrnsir.r

rur{o.rorfifl o-ai1rfiuflruc rafiu{ouns 6.67 }ru6hrluuanrn:#o,rdr6'o naut?o',tu5tt

y{u'ru'rsrasanrfiu {fior#o;irurrarlrufiornr:uaotnrtnf,fin f,aoo#otn-un'lrfinu1rlo.l

Pronjunyakul ttils Linsuwan lUl:tylUrUrn:rmfrUd (aO) fiyrua-n:rnr:fiOrf,t HgV

at'lu#oton r fiuttneuuru{runnrr {ounc 4g. 18 uns{ouns gg. 46 sttun*lo-u t{u1u

rwrtuf,turnn'irrnrturu ({ounc g7.zo une{ouns 20. b1 arrun"tgTu)

nruffnd r-nufii uaronJs (+r)'tddnu'lluurrornrli{Hu'lu'laurotur! Huatlrudn

vaHBV iouns 26.8 Anti-HBe IUl.r Seronarker dfiordurfifidEr:]n1lFl:lqHutlnngi1{0ti1{fiuuAArd(ti

riunfn'rlnrtofrd nu'iror6rrunndn:'ler{u Anti-HBe {itntlqFt;t1nlou ot U5Eills 3 [vl'l$l

( p ( 0. 01) usrnrn:fififiilfirfiu:u et r fiurn-unrrat'ml'l r fion fififiu:c lTnr:ounriilruo'udn r ou

unsrifivr"rtrulul:wsrura#,r,rsi r flfruru qgfifln:rn:1afiu Anti-HBe il.t fi,rri.rfi,ra, rtrgt.1,

r frut oionr:60 r frolrr"osr-u0'n r ilu fl

a

a

rfiruf,u tuuurh rnsnrw

i1u ufln;'irfirfiu'r

1i'tu rmrfufifinfi,rouf;ronfrr fiuru:rufirfiuarur,lrirufimr.rrulufio{yrerilo{er51erfiooA e - -.utt uu a d o v t tt 9td{ O'tE I Uu]UlFr?-10'tElotu r n0n u5oilannfu?rarn r noololuuna n"N 1u

c

rou'r Ftif,uts (sg) finurfunriruUantn:1x\ty{u"lu1nua5u1un nu HBV narker


2t

a

a

oocoAX-o-su-dr ilflalum$nun,)5nn I d01't56lnuon I flu u

riuos.rusifi:ruit'mr,rnn'l:finurnr:6orf;o Hsv finrrrutfiurflotn-utno#tfrrfrun;iru

:'nitrurflfl lOU Vahrman (ee) 1uil rr.O. 19?0 ttns5']U{1u7to{ Hersh (qS) fl 0.J.

1921 'tun6irur-nsir.r rn6 ,o-or"'nri,rfirfrufiuoru:-urTutoufirru'ir rnnftrfrudrfiur.Iedufifufifi

u o du o I t da d, 1-.-oa-. -. ^.

ol.lilitNnu6nun"HngtIU0 HBv gtoNtnNHilnr:finurfiuu-u loa Jeffries (44) :']u.llu.lrfinrrruunil0{ HBv mlundudru'tfUnl:fnur1unflflsr1:Ft6oe1on'l.i rn6ffirr{ud aoomflo.ttfi.l

A u d - . 6 3 o r_-_tr-r_^_ --. -___t.-..v - €

n1rfinu"l1u0-{nnu fi,rafiuauu'irnr:fiorfio HBv 6l"trut5nfiosiofd,iru ytr.tn'15fitHdil-tlvfui;

(45 )

sznuness unsoils (a6) ldfinurfi.rrunfin:Truvr1\t rno#rufrudrun'lrttwin:salu

Y d - .q u ( ^ d -ot - d^ v 'tfio ttgv t^tui1 ntiileluluaff$lylulinrt tn0, Ssus t1n1ua\tn'trfJ[1^l$lilNl',1ufi'lurn:1rutHFl

Unsnl:i?&tt$tFlyn{yl1"t:uiTn (AnaI intercourse) tfiu:UuUunr:tt]1i,fi, ,rU dilfri'rU

6 - 6- -^ -- - ct qn'll6nb1uoil schreeder [t5lsFltl& (47) lUu1u1uvl"lu0{ tou'lnu

wu'irnr:fi r nof,rufiudruil-nun& Anar-genital

llilsn1t6l'lu#rtnrtnrrS (rectallenital intercourser Oral-anal interco

do uch i n g ) fi oT r u #ruvr'udo d r,r fi fis nrrTrgnr.r n fi 6

0ral-anal intercourse

A 9a a U -06u'tulo?1n"tri'tun'trtyt"htyt'l-liufin nl'lrflrfiourotmastotiiomrr:utinrurn nr:fionadruiSt

fi6.rfl',rn'iri8 oral-oral tlfls oral-genitaltl

futofid c1nn1xfinu''t?l0it Christopher ( 4e ) finurfuriri, Unf,fiol:nfiqeiovlr.l

vdouonalnuu{ .

a

u u ( u . 6u 2t 6 w 'rnddlrr{uri yruirndruuruinErrt [flFfuonr1n11ildnuo{ HBV :au'als 13.9, lu}lfu{Tnn'lil l}1rl

It6d6Lt@l-4u

1uU[tOrdntrt0U SOUas 30.7, clud'lulnllruty'lfl ?{Uf,{nilXoails 64. 3 tlfluU-u-.u.-t)-50uas 47.1 6t-ll4Tu1undilU''tu5-n{',lNtn6 {OUns 80 Slulud',lUOrUd',tUsi

tl

a5ouils 13.5,

d"tu5n6l0il t$rFj

u

se flfiuru


22

t

Alter rncnne (ag) ldfinrrnrrfroeioua{ HBv fun;iru{ndr'! rnrnoufinurlu

e nrlr 6o n{l{riru nfifinr:nfirroionrr rnn#lrfud (sro sroup) unen6iurinfinur

ruurimarn-utunra{gorruinr turull sm uilrnrrfrnrrr.iaurfiutuniilfirurr [ocfiro"r

ndruuufirot

a

I

. A o I o o s lu t s s € u tt @

sul'tludumur n'l19r6lrd0 HBv No'l'lu5lufiu6nucl"luluovt'l{ rv{sl6lxmJ6 grSrtnuu'lrnu

fi rrifi omru#lfrrri'riunrr atio unr r, n u. r" aun ;irurinfi nurt.r r fl ut ufi r o'r. #u

?rNo runnr:finurvrutdurdurrTurYuuufirurrluniiu srD runnr:finuruanrtrflrfiu'ir nmn

, fi uo tunlrfi q, f; o ngu, fru$unrNe"nnuriyrr,r r vro#ruvTud

tudxtfiounnrnru 1986 - finuruu lgez Baddour [Grsarw (so) ldfinuruuJ,ou

uaau rilu{nonrsao rfio Hsv tuan{fiT ot luofifinrrnfisrsionr,r rnnftifiud ernn6iilFr'rorir.l

136 au nuirfi ze ou {oung lz.6 fifinr:fiqr$o HBv $nsnuflq{flarta-rU s ussntida o: . t( . cto , v aa . A o io v w (vrNo'l1N6lNilU60U1{Nuu5llnrunl\rilnn n6t1?a0 suusrlnl (E'lu?uil) lrNrnrtdrulrud

(p < 0.00s) u:s{6nr:fitrnfiosianr.rrnn#ruftid (p < 0.02) raae*uruinhfrud

Yl'lltt$lFl (P ( 0.001)

fi.rrrru{ rfruu:r ryrrtriraurirufioriru Endemic area rdurfiurriuu:c ryrotnu fiaa,^no

5'ru{1un1:finuruo,r Goh (sr) fi.rnr:fiorfio HBv 6nu'r1uniiru uru-r,tfi,t orfinfirou

e"Tu1u g60 Fru (d'lu lzt nu, uftr zag nu) firrl-unr::'nur'lunfifior:ofiodomrrrvrovul ,grdudttee

#rurturi ludr{:srfcrrarn\rttsrloouunl1ail - 6-u1ral fl n.rl. t9B2 uilo,rlrirfiuhtrrrlr

#rur1udodr.r firiuarniq rs u'irt:s uc r rnrnr:u:s nouorfinfi r dun'uamrudnuo{ HBv

antibodies nrirt6on'ltruUnuo{ HBv antibodie" rfrrufiurfruilor ttitun-tqlnuignouI

orfinn:ufl Anti-HBc finurrrfu r filfiunrxoru

6t tue'urufifionrrr'rd 1b? nu6A

57 .1, UfuirSOUSrc 62. 5 )

HBsAg positive auo{lfi 1u-t,

[ns:sus rrnr odrrfifiumd'ru Anti-HBs

fir$rrufiurdurdsrn-u drurr,rrlrfiofiururfiafu nufufiursruirfinr:fi",ffo ,ru luisususn 'lmnn'ir{r,rft{ (HBsAg uru{ouac 14.9, rafri{ouau 0.3) u#r:elnuiunouorflnnru z flddojUn15flnU'l9l0gl'lN Seroconversion lYtOgl'lalll-t HBsAg

i- ttl{1, 16 Oilvlu{n{9llleffiJ HBsAg positive (U1U:0Unsa itdn r+r aufinr-{tlinni?Efilj HBsAg Negative'ndumt!,5e,50uns t2.8, uq{r8unc 9.8)


23

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{

iaeS,er,Aaofi.rnrrfinuruo.r Goh luor"{fi unna'iriaunu g? uo{n;iufifi Hg"ae

positive tutru-ufrt fifiorflffirorfisr:rerillru HBsAB mulu6to\rfl o-n:rnr:uruual

HBsAB fiil:srurru {ounr o siofi

'lun1.r Ivrvfl qrnnr:finuruo.t lr,n'd 6noto unsona (Ez) frnrrnrudnro'r

HBsAs trts Anti-HBs luufirmtnfilrtu leafinriuafulornfi 111 i"tu fiNrn:re{nurfi

dnrunlilTinrirufli nriloruqrul:nfiosio n:s yn'r ir 6t'rs-l:nrtu r uiuu r fiuurYuniiu,rft,r fi

ndrrrun#re'u'rurlirrTu ,fiorornfou HBsAg b i1u t{oun* 4.5) rnu o'ii-rrr"-D - o i . -Ut96 x'lu (l0uns 86.4) ur[\lv'ltta\t{'lUllU HBsAB 12 r1U (50gns 10.8) [[nE Anti-HBs

50 l',lu ({ounc 45.05 )

E'tnn'n6nH1nu?'luru{ 2,ZO

nnIU il prevalence UOil HBsAg lt5ls Anti-HBs

{ouns 90.99 eir,rriuuft.rusi{{rmflr dlfirfiul{auntunngir{duodrtf,o r eu uft.r :a r nfifiv.o

55.86 r?l'lUU

n.ttfinu.tusit Tantivanich ttflg Udomratana (53) finurturllft.r e ndtt. d o i- --, , J - q A o

n{urrnbOufttfrU]{ftl[n\l\t'lU vlll'l:Un"l5lnu'lil6ln1un']$15nmufii q"lu?U ?8 Au ttnsn6iill-tA.uiqqd

!tru{[a{it']u[n1nN1lhur1unnrfiurs ri{uli{Urfi e*uru 42 flu ruiroIruuflilo,! HBsAgI

Anti-HBc rrudltur,rft.rna!ruurn ({ouns 7. ? uns{ouas 84. g) druturlfr'rushrrrud Dt U r- | | at . q I du - g

mJtrluillauns 4.8 ttaclau6lu 13.2 tlFt'lri]rux'lIFr?'lNlrgrnfi'httluOtit\tFliu6tlo'rM'ht

(oi1e HBV narkers 1oui6 Enzyne Innunoassay Abbott) ntrfinu-rrtifi#r,fi'6 a - v a u €v A . o u o

r fiufir orrualo'ruro.r r rcfitufrudriunr:fiosioror lriaCI'uo-n I ilu fi

ec t fiu'irnr:finrrRruqnuo{ 1x:'6tfruo'n r nu fl fiunr:fi r yrnf,urludn\ {nirr r no ,,rt.

r-noh{,no u^*ntoRo\r r?!d r1c{u.ir railfirfrururdrrnfi4o6onrlffiTiounrr rnfl (44-bg)

nn{unrrfiodotunail{neir{ tflo egfioeioernto{firfrurnrl, (camier) tfilrnfianrurir,r

u#{fiu:cq'rr6ou rrsir,ra'.rernfiu:sq'rr6ourfiu ? r"uu#r runr:finsiar?oururn (sa)

alt6ts

etua'l

AAflnn


24

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aat

u?rt|

Ad A OU28fltUl{n'l:2!tu

g.t ruuwnri{E

,t-

nrtii'ufiuu'rrfrrfiu z dru

;irufi r nr:i{urfrtn::ruur rfrofinura-m'ro'nldnuo.rnr:6or$0l.ri-dsr'uo-nrilu

{ fi tuunnrnxltinrtglu'tnn'ufi{ [fldi

rirufi z nt:iq-urf,ri rn:rcri (rrnarytic study) rfioflnurfi.rr1e{urdu.rsioo t -- @-a u ct d a - 2

nllaolu0'l'tl6lCIu0n[5lu u luuan']n:ltityt?J-ltnnn"ltl}1{ lndt lgtuNnl5$lnb'lonut

- al'lil sero-narkers HBV luuoflln: rfirouutrfiundrfio,f;, ,ruo'l

runsnrirutufiorfo Hsvt

- frnurrJedueir.r ot Ernuwctounl$ ruiuurfiuu:cudr{ndffifror#o.pI

HBv n-uneirufi'til6orfio Hsvt

od,rfle{ueirr r o'.rniirrrir,fiun.:6nurfi.rt1qfuiirffiuruofin {{ rfiu

{ nr:itni'lsrfi,rrcrruou0{n'}:6orf,o ngv teur4rduqinr"rnnri6o,f;o ttru Ernn'r:enrq

nr,rrio,rufirihnr: o',rrfunrr6nt.ruo{0fl6.r rfiunr:frnurlufrnunsuo{ cnoss-sEcrroNAt

casu-coutnol sruDY roufinrltfifio,fo rru rfiun;irufinur (case) unsnliilfddorf;o

rflunriruruiuurfiuu (control)

3.2 ilrstrnrfiilnur

a i o* a uiFlnu.r taynsUanlniynjousr.t.lulull{tr?Jlu1nnluvN tyrd5 uns tUuHyrouluuoutusl

tlll

u0{a1l.rriogrx'rruU0{nTir nunn'lni" ru dr{{uc"nre ru{ufr z-B trub'ruu tAt.st. zsgzI']fiqru.utfrq5u sz6 Fru Copyright by Mahidol University

26

a

s.s rniorinirfirunr:i&

2, iltrufl0un'lilaa3. lruln:nothrnai

it''3.4 mlSnrnTnlrlaxf,

l. firad'rrrfiootuniiuu:silTrfifinu'l

4

1. rnun?ou'li!rnao leetuunrfiuturrriasfin/uHun quffiu t8 uilru

z, l#uuunoun'lillouuigi1ffintono"lgtouto{ (self-Adninistered

questionnaire) un r{utuurt:rufirilrflr'teluflae"nruraiorrififrnwlun.t:ritutfiuu

qs1finr:fl$nrufiunu

g. irn:rsfmrfo.rufiri6nr: u"ro'rorirt r6aodrdCirsritqm serun narker

Hgv lduti

ql?ilt/l'l lleBatitis B Surface Antigen (HBsAg) druifi

Beversed Passive Henagglutination (RPHA) (Center for fnnunodi.aglnostic

Production, CIP : l:tmlturatrrur6ufi)

- nllqln Antibody hepatitis B virus (Antt-HBsl d'lUi6

Passive llenagglutination (PHA)

ol'lqu'l Antibody hepatitis B core (Anti-HBc) drti6 PHA

dto:rq ru rflo.ru0ri6nrr1:rmrrurnnlrlr'r rflu: rftauunn{rfiorfra un,. .6 8 a u o. o '

niirurifio r fio une finurrJq{ueirr r r u€uu r fiulrlun6iun'{ do{ elnruu;tounl$

3.5 n,|flrlcmnfioun (oata Brocesslng)

nr:i e'u ori f,u:g u. or.rourfl r oi o { tillor no rrfir r no{ rou fi tiunouft fi

1. ntxa6loun?lil5tNu:rfiu0{nuuilounlu{

z. n{rl$fion.r:rio

g. n{ r}t'f,'luuuuyh{unl ru'a


26

o

4. riufin:rln 1il Disketre

5.

6.

sr'rtturlunr:finur

{

a

- :rulfrn:oun{roior6ouI d -A@- r4u1u{'luyru0usht'ru

rlrirfiursett

nr:60 r fiotufii, rnru

- nr:#raia r fioolurruu:se"r

- nrrld:-urlq{u$,ir.r t rriu ntfiu td:"urf,onr

- nr:1d:-uafi6rusr'lutrult

- n'lSlrfnrri'nulyru'lurnrirjruduo-n r ilu!

oI- nr:fiorrfiolugrlounixa q o € o I tv v C

- nllil 1Y'l9lfltl$llld , n'l5fle I d0q'lnnflImt5tl'l{ I fiFl , n1561'l6l0ilyl'l\t I t{fl

z.'frruu:Enu rdrrrioX- n'l:gtFttdD HBv

i r nns ritoutfilu:un:lfi r iq:rl spss/pc

05? E;loun?runndor fi nr{'r 6o *.r nufi

a Ctt3.6 n15?ln:,lcuuoua

1. firurj:fo:u ffiuri

- t l1$l

iln1uR'lr{6tN56l

- orf,n

- SsBs lx6t1n1:yt"ht-tu1ul:{}IU'lu'l5l

:rulfrsio r6ou

e'urudmfinlun:0ua{'lttd tt- eluxulrN51uloll

eCopyright by Mahidol University

27

t

r. t rnttrinnrd nnsiouas

z. 'nafratnni?ru&fid $arillm.trruwritr lffi1fi Relative @ds, chi-

aquare-testr Flsherts cxrct test tlfls Z-teet i

.1I

',1,:-i].. 1-,1'.. ij

l

I

,!

I

I

I

:l

..1I

I

I

1

I'lI

{

a

eCopyright by Mahidol University

28

aa

al

-n1

OUH5tn-l:1rlu

IU

ru n n'r x fi n u1 flq q1J t f, u { ei o n r : fr q t fl o 1'r i-f, a-u 0-n t du fi 1uuamn:1r{nu'rura

I

n*lmit'.t rfldx fi.rrdvrrnr:rfiu:rurrruflailnqrnuflnrnrnrirurflrumu qrurufi.riu 326 nu

6r'rru1inrfiu:ru:rrutfi egs nu 6r,fioloorr'nr.ar isrundrufirrirrflr?orun rflun;irufirdfio

r'ofiufiotrTul'rr-Rsl'udn rau fl u#r 1{ounu s. g3) rflun{rufirritriorrruirufioerntr ruel

oir,r r ({osns t.bg) uaurfrunairufitdarm:nfiqqrerrd ({ouas L.ztl runernnr:finur,.2

tl6l9ht'1q o{u

1.

aE,iar.r rioruafiugruuotnriruunarn:fifinur'tduri rnro 6tn1unrtlf,Ni6t oru orfiu

rsus rrnrfin'r,rru1u1r\rlru1u1n :ruldrior6ou elu'lunrurfinlunrouo{r erurufifi:rurd

1un: oun{r i 1 u160 0{ ar ousr:-r sio r 6ou fi n /uc{unfi ufiffi { tu'lui: t wururnu u 'A.^ tfioodto:rqur serun marker HBV1. 2 U0ilnm{U0\:U0Uan15 illnn'I5 lll'ls

tffnn Hepatitis B surface Antigen (HBsAg), Antibody Hepatitis B surfacei ,Jo B(Anti-ttgs), Antibody Hepatitis B core (Anti-HBc) ttlOttunnn$Jvl9loldOllflsnAN

J,oZillilaqrd0 HBv

d,a2. nan'lr6nuluarnssu'lnr^nur ri,ri tnflrf

a a @ . ia,- ; 'fi nurrlqa'u!,ir{ "l fi fuir u r fr uT rio.r rYunr:fi o r fi otrs-iln-uo-n t du fl luuoarn:

I a u . .d d t , Jo H - '. 1:,rnururnnlrlht rs{dr loufinurr]iqlusir{ 1 rrliuutfiuursra'irtnairufifisrtfiorTun;irufirdfio

E u t 4 i - D)l

tilo lnud lsrFl ilnluR'tllFltlS61 0'tu 0'td1{ Ssuu [1nlvlyl"l\t'lu1u15{v{u'luln llu19lsl0

t' 'n1ugr:oun{r e1urutifi:rutdtugr:ouo:-t :tuldro\rox0urrr-'rsio r6orrro0l.r q"]ulu6lil'ldn'luFrT0un51 il'lu? s

tarirdu:uar nrif,-Nr.iilrf,oqtu'{ruu:se"rr-u nr:ld:-uarifi[uer1u{luuisa"r n']sririi':u.rrutt{- It A o d a Y -^ u v v d . tt s ry.. s

[[6rs /t4i06trurf nnrouo:i finr:60 r fro1r:'tsr'uo-n r ilu fi nrr'Irinr::hu-l]rururnlrn{rjruor'u

dn rau nr:fi r tnto#rur{ud nt5illdouvt'tlt t tAlrl


29

t

l,sa!0l|a5t tnmnu't t d{ t|5 50u'l

-

1.

1.1

;n'r51{n 4

UNu0N6rmr5"lu

nrrf,nr$orrr-afiudn rau

tfld

fi (Hgv) 'lffiffar:1t{tornnn'iltrht lnt: qluunnlr

elu1l| positive elllunm$ Serun narker HBV

ln$l eanudyrvto610u

qlu?u

positive HBsAg HBsAg + Anti-

Anti-HBc HBc

Anti- Anti-HBs +

llBs Anti-HBc

dlUA

?lf['l

42(14.r) 25(5e.5)

256(85.9) 133(52.0)

3

10

2

11

t2

50

2

42

6

20

:'ltJ 2e8 ( 100 ) 158

( 53.0)

13

(4,4)

13 62

(4.41 (20.8)

26 44

(8.7) (14.8)

.t?

" dr rnulux\r rf;uumrrdr{ouns

tfl6 (n1l-lod al a"rnn1:finur1un;iruna'rnr ltitmJltnnn'ttt]ritn{d: E"tuxurrC'

z9B ou drurrarlrilurnorafirr qlmu zs6 ou fisrfru{auns 8s.9 rfrurrtfld1ua"ulu 42

au fiorfiu{ouns 14.1 'lunrirurnrtulufirifior#o Hgv zs au alfirrifinr#o t? Fru fiorfru

{aanc bg.s uas 40.b 'lurflnr,rft.rfirifiorf;o ttru 11u'lu 13; nu rirlifin,#, rzg ,u

horfru{ounv 52,0 uns 48.0 q1rua1d'u o'n:rnr:fio,#0,*firrrirn-u {oua, bg.o

*Copyright by Mahidol University

30

a

nr:fin r iarr:'dn-udn r ilu fl

flnTtrnffifi:51

(HBv) turnnrrlr{rornan.|uft{ rnd: e.luunnrl

q'ilnu positive E"luunn'lx Serun narker HBV

6lnlumn

6lU56l

elmu

positive

llluxu6flno610u HBsAg HBsAg + Anti-

Anti-HBc HBc

Anti- Anti-HBs +

HBs Anti-HBc

{1f,o

I

o!

t14N'IU

,t{u'l

Iun

104(34.9)

176(59.1)

e(3.0)

7 (2.3'

2(0.7,

43(41.3)

103(58.5)

6(66,7)

5(71.4)

1(50.0)

2

10

1

0

0

18

38

3

3

0

8

15

2

0

I

13

31

0

0

0

5?rl 2e8 ( 100 ) 158

(53,0)

13

(4.4)

13

(4.4)

62

(20.8)

26 44

(8.7) (14.8)

4J ' frr t6tu1u?{ rf;uunsrrrir{ounc

5tn1un1fl6tutfl (nlrllfi s) fignarn:firflutan ro+ nu horflu{ouoc 34.9

iln'lun'llt6lu56lri 176 nu 6arfiu{o?,as s9.1 uffrueluru g nu fiorfiu{ounc 3,0 uri'l

z au Aorfiu{ouns a.B rmguunn-uoti e nu Fnrflu{ounc o.z

!llnn'll'l{ rrilo.rlritfiu'irunarn:fidrunr:ar:nudr (,d, uliru, utir) 1u[sins. c! - o I - . - -,ia 8 VX - i e a t, I

nililNE*M?unllonttit6litnxle"utulNsrotdoyndu 6t'il4iuunarnfyttilulilFt Huile.lmur{lNot r ., -

oro I -

t t6qrfro fitrnn'irElu'rufrdorto 6'r:runs rdun.tunr:r.t+


3t

t

r'unrl{"n 6 nrrfia r iiatrr-iln'ua"n I fu fi (HBV)'lUuna1ntlt.tiuttnnn'ulN lrfir a.lurnn-u

a

nflro'lutl

11UXU positive q'l[[Unn-lN Serun narker HBV

o'luI

elmudyrytoSl0u

E 1UXU

positive HBsAg HBsAg +

Anti-HBc

Anti- Anti- Anti-HBs +

HBc HBs Anti-HBc

2A-24

25-29

30-34

35-39

>40

50(16.8)

84(28,21

66(22.1)

39(13.1)

5e ( le.8 )

20(40.0)

35(41.7)

42(63.6)

24(61.5)

37 (62.7)

0

D

c

1

2

2

0

2

3

6

7

18

t6

IL2

3

c

c

5

I

8

7

T4

6

9

5'tN 2e8 ( 100 ) 158

(53.0)

13

(4.4)

13 62

(4.4) (20.8)

26 44

(8.7) (14.8)

)u4.A* n'l t 5tu'lu't{ t nuttil9.t Ft'l5ouns

0"lu (415r'1fi o) lundiluoiltn:fi6nurnu'irfioru#.rnsi zo fi$ururf,nrruo rir,r-Trira. _i-_ A C. c, u u --v01u e5-29 U iluru'lnvlf,o 84 nu 6otilu5ounu ZB.e olusr'urortdud dr.ro'lu 80-94 flqll

, o d. a ! - U . -_ o.3 _ - 6 6 vefu'lu 66 au notuuT0uilE 22.1 U1'00'lu$t-{tta 40 iltu1u e"u'lu b9 au dsrilufounc

19.8 drtou zo-24 fi Elu'tu b0 ail isrrflu{ouns 16.8 nu il6rsri'hroru 35-39 fiLta6gt

aluxu 39 0u ootuutounE 13.1

t .ragr N0il"151An15oto t d0

dt20-24 U ilflsnflilO1tJ 26-29{c

,idtt6gnililOlu0u al ilE'luxuHFlo t dollu

HBv lutteiilsndruo'tu nui'Iluilo{ndruaru 6alltl4 -a-^_-._- q_^ _ t e! t - ,, rA yu ilq-Tuxungt9t I d0 HBV U0Un11E'lu,tut^tltisro t ilog!

, r,,a y lXHBV 6l{n'}'tt^tlil9to t [014{6tuog

nflN0-rutt

61"]fiT'U'lU


3Z

I

a6nT'l{n 7

9AdUUU6n'rlnn ldal'l55lnuan tflu u

orfln

(HBv) lilunn1nrlr{rufrrnanlum rnt: e"luunnil

q*Iillll positive e-ltlttnnlil Serun narker HBV

orfivr a'luxudyryto610u

E"lu1u

positive HBsAg HBsAg + Anti-

Anti-HBc HBc

Anti- Anti-HBs +

HBs Anti-HBc

'qnfinrrunlnnru

61s010

@ A.flun{1uhu'lug

zt Itrun0nulu

et ai aI q'114u'tyt t ytnua

cn'l5ilytytu

v v A- oI qlUU.tyl5{ 6l

dIy{yru

et etiI qluu'lyty{u'tu'ln

At^tu'tu1n t ytFll{o

l^tu'lulaidtfi}|(

tttlylu

v(ylusr[[]ryru

qq

yruolu'rNU

Ur v €0"rdlufluatrvtYrug

56(18.8) 31(55.4)

64(21.5) 31(48.4)

4(66.7) 6 (2.0 ) 0

02 ( 100.0 ) 2(0.7 )

10L2

10

t18(54.5)

31 ( 56.4 )

31(44.9)

6(75.0)

1(100)

1(100)

2(66,7 )

33(11.1)

55(18.5)

69(23.2)

8(2.7)

1(0.3)

1(0.3)

3(1.0)

1

4

2

0

0

0

0

0

3

1

0

0

1

0

4

16

13

3

0

0

2

6

1

6

3

0

0

0

7

7

9

0

1

0

0

5?$l 2e8 ( r00 ) 158 13

(53.0) (4.4)

62 26

(20.8) (8.7)

13

(4.4)

44

(14.8)f

* 9l'1 t n?,1u't't t fruit;lo.t rir{ouasCopyright by Mahidol University

33

a

.t-.iov.qo'ldfl (nT'l\tvr 7) qln 11 6l1u1018n 10[fi mrn\t1un1n.l'lil6tuo1q

vg,?{un{1uf"l

s

{

ri,Uruf,onurfr r{rrarirfirvrefinnr:rrmd r{rrarirfi:',rfiumti r{ruffrfinu'rurn y{u'ru-ril

ttrnfin nururniurfrw unvrd fi'unurorf fiuorurffu frdrun'uounnf tuetuluflfiunnrn:ru

6t'ru'r$ru'ru'lniurfinru'r{rrutunr:frnulu'rnd4rt ,*.u un nu 6nrfiu{ouns ei.z ohrl,

:o.r lfiuri nfinrrudrurraf,orrulr? oa ,u arrfiu{oun, zl.b rnTnlrunlnrrruaso-ln b6 nuA 6 !, o U e, eti aFl@[Uu5Ounc 18.8 v{?J'lu16ltltoilo 55 Fru fouas 18.S ri-rrafirfinuru.ln 33 Ftu Fto6 u ---q _. o_.F..g. v aA o dluus0uns 11.1 ltl{vlu a1ulu I ou dotiiufounu e.z r{ruurnrilnuonlitrttytu 6 au

6 6- et P^--!l-i y o, -2_t^- ct c _ - i u eooluus0uilv 2,0 tEruurfii.til$v{vtti 2 nu {drurTuErrryrnti g nu r{uonnyrd r au nua-lu-lfu

1 ou o'tilnlo-u

t'lnr.r"'od z riofrqr:nne'uruurrnrn:luudnunalu aa rfnlirfi s orurorflrq fifirtqluluunnlniil'tn n;irr6o nururnitrfin min.nudru ruf,onurf min,rruyr.rrr?,.rr6rr01o

o g,,cti i -^ ^ 6 E - ,gllu'lu'lSllvlFluFl tlslslE'll4u'lvtflUrurn ttastlonl'nteq"Tnunt:6orfio HBV 1u S n;itfi nu.azr-oZ?'l fiu1u1n[floua uE lmunliaotdo

minrrun.trt?'l&t6tso'tct {ouas ss.*--2t A a dlu :ouns 48.4 llnsflu-lu't6txd"tilrr

cjn.r r [il0{1{1uqr:rtfi z

HBv 31 au it"rna*u1u bb nu aorfiu{ouna s6.4a etd ttrirufirfiHg'rulflfouns 84. b minrrufidru rufionuq

U_v.e,idToune 44.9 6t114:UnnN01itfl0u 1 [rnEl-lu6tc iduo

44

19823


34

I

aan.l:T'| I nr:f,nriorrr-fldr.ro-nrf,u fi (mv)'lnna.ln:lirrgTrnnalxi! rrd: iTltnmrtr to t aaa$n',l rnult{ tgrnn

. at'

lsgc t'laTt

yn{.tu'lu

1fl. tfll

e'M'tu Bositive elttUna'lU Serun narker llBV

ql.lu',lU e"lmuI

6llll0flOt, posltive HBsAg HBsAg + Anti- Anti-

Anti-HBc HBc HBs

Anti-HBs +

Anti-HBc

{ (45-9), L0

91(30.5)

77 (29.81

130(43.6)

37 (40,71

39(50.6)

82(63.1)

0

I5

3

2

I

15

16

31

5

7

14

14

6

24

2e8( loo) 158

( 53.0)

l3

(4.4)

13 62

(4.41 (20.8)

26 44.

(8.?) (14.9)

. n'r rnulu?i! r$uunmdr{auns

:eusrrardn'NrululrrmJrura 1nr:rrfi 8) n{qrrnrn:finto,lututr.rt, -|/'

nulu'l6l uruftugi ro flf,uru rilN'lnfi\t tgo nu finrfiu{ouai 4s.6 t0{6t,{rulrduri m!1IfinTruururbsn'iruiorrirfru a fl fieanu 91 nu fiorfiu{aana 30.0 Rnflrurfiumirud

nlrruurud?{ 5-9 fl q"nnu TT fiit dorfiu{aua; z9.g

rion'nrrltl'nnunl5finrf,o luusinsftirr,ru'ir n;iqnarn:fintrrululr!y{?J-}uln

u'luurstl'ltu 0-4 fl fiq"nnunr:fior$o gz nu fiorfiu{ouas 40.2 ndriin"nrudu b-9 flIta6 It

fiqtuTn s9 nu finrfruiounc

fiorfru{ouns 68.1

b0.6 nnsn;ilfiyrtrruurufi,rud to fi$uru fieturu 82 nu


35

I

nrrf,nrforrftfirm-nrnu fi tmvl tugnarrlrrrsrrnnn'un rrur qarmmr

nsrfidCIrfiau

:rsldeiarfiau

(U1n)

eluru Bositive e"Uilnm$ Serun narker HBV

qTrxu e1rrujnn06l0u positive HBsAg HBsAg + Anti-

Anti-HBc HBc

Antt- Anti-llBs +

HBs Antl-HBc

{ ( 2,500

2,500-5,000

S rooo-?, boo

7,500-10,000

) 101000

49( 16.4)

184(61.7)

45(2,0)

15(5.0)

'5(1.7)

23(46.9)

91(49.5)

31(68. e)

9(60.0)

4(80.0)

1

10

2

0

0.

T

38

13

2

2

4

tz

6

3

I

8.

24

I3

0

2e8(1oo) 158 13

(53.0) (4.4)

13 62

(4.4) (20.8)

26 44

(8.7) (14.8)

. dr rnu'tu'rl rf;uuaorir{ounc

rrsldplo r6ou (rr:rod 9) qnn'lnr'lu1:rm.lru'lnn1[rw{ rnu: drulr,rr!ftrurd

dordoursu'itz,E00:5,000 u'lyr fietu, u tg+. Ja - ot. a gt .

nQU?fN5',lulnno tn0uu0wt11 21500 ulyt ll"luluI

nu fiorfiu{ouds 61. z fluo'u:a,rrdrrri

49 nu dorfiu{ouas 16.e nrirufiftru

td :au'irt b;000-?,s00 ulyr riordau qlu?il 4b ou fiorfiu{ogne 15,r niiffifi:ru

tdtgra'ir{ ?,b00-l0,ooo urneior6ou qnnu 15 nu Hoiflu{osng b.0 unaffilfifi:rs

tfrirnn'ir 10,000 urndotfiou fiqturu F nu fiorfiu{ouns L,7 nrunlfiu 'tuurinsmiu

fr,rndrrfr.rfru firrurunr:fior#o nsv 6srfiuiounstde-rf, n;iufifi:rurdeiorfioufiogn'ir: .J

21800 urn {aaRs ae.s miufifinsr# 2,s00-s,000 uln roung 49.b nqrnftrT urd

5,000-?,500 u'ln {ounc oe.s ru!rufifi:ruld rcuir{ ?,s00-tr0,000 mn {osnc

60.0 rf,snr!1fifi:rurfurnn'ir 10,000 urneior6ou{ou6rs g0.0


36

t

ioenr:rfi 10 nrrfinrf,al1:-f,dtm-ntflu fi (HBy) tnnnr:lr{fs.ttnannrn.t trt: r"ilunn.ln

eAl'llstmenlun:oun:-,I

ehrruourfin

1u

oxouol-')

E*IU?U

positive

aluxu positive q'lstunnlN Serun narker HBV

cT.t?uI

dy|nailou HBsAg HBsAg + Anti-

Anti-HBc HBc

Anti- Anti-HBs +

HBs Anti-HBc

{<4

4-7>7

188(63.1)

80(26.8)

30(10,1)

103(54.8)

41(51.3)

14(46.7)

I3

1

I4

I

36

19

7

16

I2

34

T

3

5?N 2e8 ( 100 ) 158 13

(53.0) (4.4)

13 62

(4.4) (20.8)

26 44

(8.7) (14.8)

t

-_u-Ct.g,I nl I nu'lu?\t t 6tult6lo{ e150uns

I 0 ) qnfl'ln:drurra$fi nhnufl illan.lun5ou--@- l! t a--.- 4 o 6 a '05? uountt 4 Ftu NE'uruil,r 189 Ftu 6oriJu:"auns 63.f nriufifiqfuxurtNlanluaTou

u . d a d ,, , ia - a qa5? 5s141'l{ 4-7 au N 80 Flu rtetiluiouns 26,8 $ncn6irufrfrElurunmfinlun:ounti

u si,r n;irrfinu'irfiqrurufi 6elEoactl[d0 HBV AnruuS0uslv 54.9,. 51.3 [ns 46.7 o1Nilhlu


37

t

Jotouuan.ll-l.ln 11 n1:netd01?:Slnuonl6lu u (HBv) luunalmliittrEf'ltnan.l[friilffit e'uunm$I

r"nn wifi : r u I #1un: ounr'rI

g,ct Aalu'tu!{ili'1u10

s

1uq

ax0uFrl')

alu1u

positive

?'luxu positive. a"ilunfl^til Serum narker HBV

E"luxu

dyryrFr610u HBsAg HBsAg +

Anti-HBc

Anti- Anti- Anti-HBs +

HBc HBs Anti-HBc

{1

2

3

4

5

8t(27,4',)

136(45.e)

41(13.e)

22(7.4)

16 (.5. 4 )

45(55.6)

73(53.7)

22(53,7 |

11( 50..0 )

7(43.8)

4

I0

0

I

1

6

5

1

0

18

28

10

4

2

7

L2

2

1

4

15

19

c

5

0

1'.lN 2e8 ( 100 ) 158 13

(53.4) (4.4)

62 26

(20.e) (8.8)

l3

(4,4'

44

(14.9)

a* gr-1 r ilz'lux{ [ f;uililo.tri'riouns

q"1uru#fi:rutsitt{Ft:oun{r (n'lr1{fi 11) n;iruunnrnrfifiEruruaifir,tuldlrl

-

rr ou e --r d .;_ o F,.,!1. - @ a --2, , . doua50ua5? 2 Flu tUunaruvtvlul.l"t0t4ilo 0otilufounv 45.g oluriurorfdrrri n;irunflirhrufdfuItrrlUua6u

Fl50uFl51 19lu 3 au 4 filJ 5 Flu Ftotiluiouns 27.4, 13.9, 2.4 llils b.4 gt'lg6t19l-u

,-uogr.a6l'lt45unlSgrotdo HBV lurtonsnnN tlila{:tuns [0uo'tun..|T't.l

t

6( 9r'll'lil yr


38

t

nr:frn r $arr:-f,n1ro-n ldu fi (unv)

nru:ru'tffuot ffi ouffi-?ia r 6ou

"luqnnln:1:{nnu1fln1ur{ llTd: elltun

a51ulouo.l

n:ourrirra

o0 r9l0u

(u-lyr)

E luxu,

6yrlro610u

e"lu?u

positive

e*nJ'tu positive elilUnn'lN Serun narker HBV

HBsAg HBsAg + Anti-

Anti-HBc HBc

Anti- Anti-HBs +

HBs Anti-HBc

I < 5,000

5,000-10,000

10,000-15,000

15 ,000-20, 000

> 20,000

63(21.9)

150(52.3)

3e(13.6)

28(9.8)

7 (2.4)

42(66,7)

83(55.3)

tL(28,2)

t2(42.9)

4(57.1)

2

t0

1

0

0

l6

30

5

7

I

6

15

I

2

1

t4

23

3

1

1

5Xtl 28? ( 100 ) 158 13

(53.0) (4.5)

13 62

(4.5) (20.6)

26

(8.7)

44

(14.6)

' sr't rnulu'r\t rf;uunotrir{ouns

:rs16'o:ount'rsio t6ou (enn{d 12) {ouns bz. a 0ri1un;iruuernrn:fifi:rurduttn:oun:-reior6ouoqi:ar,t'ir..r b,000-10,000 urn fi.rnufi{ 1s0 nu fiorrfiu{ouns se.g

o-usiu:o.r nurun;irufi fi 5 luldnl 0 uo:'r sio r 6ou rioan'ir b, ooo urn fie"uru 68 nu 6el6. u , Ja --rt atfluSouns 21.9 n6iilfril:ru16n:ounri:cu'ir{ 10,000-1b,000 ulyteior6ou fie"uru

o6ll'39 ail 6srriluiounc 13.0 ntirufifinuldn:oun{r rcu'ir{ ls,000-20,000 u'lyreior6out

E*frJxu zg au 6orfiu{ouns g.g rncflufioufiaelI

runrirufifi :ruldrr: o un:'r sia r 6o u

N'lnni'l 20,000 urn fielnnu z nu horfiu{osas 2.4 rr"nrlurrosiouasuo,rnr:fior#o

HBtt lurleids n;iru rrnnr lunrrrl flr{ 6nCopyright by Mahidol University

39

t

aan'll,l\m 13 n-l:frn r$orr{an-uah rru fi (nsv)

eluunnrrnirur ruffitifu ru

'lrruna.tni1iitlE -lrnnnlun{ I fidi

I

t4uluit-lu

q"u'tu qnrrufi

vvhl?iltgr* ne6l0u

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elurutrifio , $, (ru )

1{ounuoiouis d''tnr;ytytoflou )

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8.

19.10.

11.

72.

A ott0nHuluu0ng

ilr,lunilnuI

ar40{ilsNflU'rU.lnUns

an lautA.ot40{ }t'tgro

?tu6tn5[tns Du-la1to

a[ili]o

nuanSsN

ltduuq'lunnl{iu

1:lf,nfion

lt.to1t4'nod:\t6l

r?dnt:N#{nildnn0tu:n55N[tns

e

ff6run:5ilu'1u

dnn01u5nltruils

I

r,6flnun::uuru{

15(60.0)

1(100.0)

9(47.4)

12(63.4)

6(75.0)

4 (80.0)

14(60.9)

4(50.0)

7(58.3)

3(100.0)

5(55.6)

18(64,3)

11(52.4)

10(40.0)

0

10(52.6)

7(36.8)

2(25,01

1(20.0)

9(39.1)

4(50.0)

5(41.7)

0

4(44,41

10(35.7)

ro(47.6)

1.

2.

3.

4,

5.

27 (9,L|

3(1.0)

20(6.7)

25(8.4)

1(0.3 )

19(6.4)

23(7,7'

15(5,0)

19(6.4)

g(2,7,

6(2.0)

23(7.71

8(2.7)

12(4.0)

4(1.3)

12(4.0)

28(9.4)

5(1.7)

23(7,71

8(2.7)

12(4.0)

3(1.0)

9(3.0)

28(e.4)

13. 25(8.4) 21(7.0)


40

;

nryhrfi rs tsio)

I

l4u'lu{"lu

e1u'lu

|v

yhll4uor<

qtu'lufi

vtoa0u

qturufio,#o (.u)

1{ounu oiouis d'lnT

fivrooou;

x2

q"urulilfio r to (sru )

U.(50u6tun0u5ud"rn5

;nnail0u)

a

te . finfrnun::rug'lu

ts. finafi-u$rro

re . 6nqm: rrr

rz. 6na.ral

tg. finfrtou

30(10.1)

29(9.7)

24(8.1)

9(3.0)

28(e.4)

30(10.1)

28 (e.4 )

23(7.7)

8(2.7)

28(e.4)

14(46.7)

15(53.6)

t2(52,2)

5(62.5)

3(10.7)

16(53.3)

13(46.4)

11( 47. I )

3(37.5)

25 (89. 3 )

5'ltl 326(1oo) 2e8(1oo) 158(1oo) 140 ( 47.0 )

a

* ru {uo1:'rir z-B uJu'luu zbSz

rariru,rrudufiuG,rru (ot"'t'lod 19) lue"u'lu tg uilrutru ldrrri finfirjruuon

utJ,agt.vttv-/lvuruun{nu tiotUtruvlurutnltnsilntilu lrorairno uO,,tdudgl5ltns6u'lo11taoa u]lunnuanSlN-- --- ' ---i r s

(. agtuuil'lunfll.t t:ttnyton lttorur: ttarun:"1f, drurrdn::ilf,-.lFtN 6norq:n::il[nsdnu$t

a@adv-dad-dntsst?t"tu ffnorurn::ruttnsdaun::ruufi.t slndnun::rudru nn6lFl-u: [1d nnfJil']l txd

-tllt

finn,rai finfirou fiuonrnrrzirirunr:finr.utsofi rto5u zgg ou elnc'tulu Bzo pru fiorfiuI

, A a - o g --.-!- ^--..-touns 91.4 rNonEt:nnqlulun-lsoqrdo Hgv tu[siasuilrutru nu'irtfroun]tuilqfiq"uruoEoi

nlino tf,Omn tnuflT\tuoitllUrUfiErfrq Serun narker HBV 1utlcincUilfU{rU


4l

t

t, gt [email protected] U0N6tvn{r40{unuan'lr-q_-

a6m:1{?t 14 6lltjn6n.l:ffi'lQ Serur narker I{BV'lufnn..|ntli.tnd-ltnnnlun\t lffiill

Iat

UUU?I

n'159n'lqtw

HBsAg Anti-HBc Anti-tlBs

qluxu

nu(iouac )

nrsuu:Ha

I I

2

3

140(47.0)

13(4.4)

13(4.4)

62(20.8)

44(14.8)

26(9,7 )

It

tri r nufisr r f o ,'tilfrnfrftrffu^oa 3 r 6

nm{nolu0, tfi{ tuuu-

-oA€5ntn{00tuo o'lEluut|uu6vaA' rauunau uSotuuynu8Z-

l:05{o8aotdoil'l'lNu1ur, t?n')9t',

firrifi r floudro t . d 68t

l nuan I uoN'lnou,NRIJF|N

uetnutla'l

o8lI FtUglO I dittJ'tnou'

+

2e8 ( 100 )

-^yio&.d.dl" 1ur,l?unu6ortourtrrun:xqmri'lfrusi lnti-ttBc nio Anti-HBs otir{ rfiurc

elno'lt'l{fi 14 ilnn1lal'lQ Serum narker HBv luqnn'lntl:{mJ'tu'lan'lm{\t. ui-, ^ .g_._4_-.,F_arr u - A 6. r, ;tHUs $lu$lvllntnsnotU0t4SolNtl4runtunurnu 140 ou 6orilufouns 4,1.0 (rluufi l) 11asfi

^-- -..-^].^.4- ,.....i ^ ^. ]---l g le*u?un'll9tord0 (nuun 2-6) HBv t{ilu lsg nu nnrilufounu b3;0 .luelu?ufi fi{fi-^--r, A Z. a A F.^-_- - e 6. rr a-eri - - o E 6nln{aal?t01450 t}l{ tUuE'lu'lu 13 au nsriluSouav 4. 4 lrilsfrrifrn.tnl{6orto o'lil[flurruurtf;gurm-u r,tiorfiunl,rsr{or-r E'ru?u 13 au fiqrflu{ounv 4,4 rdun-u a:ulffirfi---- d- , 8., -ua .e, Ho . jro g

uanlnl116l1N15nr[fl1rd0 HBV lon{ 26 au (iounu 8.7) u0nernilu-,rnu.irfrfi6nrfio


42

t

--. d g rd g ttHBV rllLtulu r4x0 r?il'lulNilriiouilrqluru

o 3 . € 6v o tlnuaot?t0fi1n0u unsilRNaunu$nl 44 nu

.a6aN1n0u 26 AU AOrUUSOUnu 9.7

62 Ffu dsrfru{aunv zo,a fin;lqnnrn:fiIt^6.uaudo3Ffotuul0u6tv L4.8 n6ts$tnltleu6qrd0 HBv

aa2. {o0'ndnu-luanarBrntrinur r iri I n:1!ti

aetoi.ay. finurtleqYurfiu.rpionr:fiorfolriao'uo-nrau fi (HBv)

n'lrt$r | ?,tdi loufrnutnts:-uflq{ufiusrndr.: fiu:c u.ir{ ndlfifin r $oI

Hgv tJqq-ueit{ 't fiulrurfinurfduri

2,1 tfl$l

;-quCr-3nrm{fr tE ultn\rm1rf,$fruir;wirr rrfn-unr:6nrf,atr:"aa-udntflu fi luuan-lnr

1:{ !E-lu'lnn'l[rN I t|d I

1uu0ntni15{tsjlu.lnI

, J--.o yHBV llnsn6rilytletnort0

Ia

rnft

oEn119t0rd0 HBV

oEaart0 rrifio r $o

5',lsl 952 Confidence

ORa

17

123

25

133

d'tuo

uru{

42

256

1.36

1.00

0,67 - 2.79

I

e'lnn't56nu']l,tu'i'l rflrfdrufin-l:fiprrf,o Hsv

nrdrgvrr,rafififi o.os

Irf,o{'i1 I }tFt til r fiurlqa'u r du',r sionr:60 r f;o

n'ltt}ht lfid5

lriunndrt qr I y{f{u0,! oti:r.r firiu

HBV'luunilln5UOit 1:{ tft,,tu't6lICopyright by Mahidol University

43

a

2,2 5ln-ruR1il6lr56l

dn.l5Ttn 16 uamnrruflifo f:su'irrdnrun'lnnman-unr:fi nr$atrr-an'uo'nrcufi

ltnnfl'lnTl5{ t*t'ltnan"ltltt{ I 1td5t

9,.aaln1500rilo HBv

dn.luR1116lN56l OB 952 Confidence

ORoI9to I d0 rrifror#o

a

1de

FIg

a14NlU

t4u'l

ttun

43

103

6

5

1

61

73

3

2

1

104

t76

I7

2

1.00

2.00

2.84

3.55

t.42

0.67 - 2.78

1.19 - 3.39'

0.56 - L8.32

0.54 - 39.44

0.02 -113.15

51tJ 158 140 298

{ * uanei'l{0dr,rfiriUAfn'rUfi o.Ob [Xz(d.f. = 1) = 7,06, p = 0.0029]

e1nnrfinu'lnu'ir RnruntfiilNrf, fi fi nT rruflrur{udfiunr:fio r f; olr:-do-uo'n r duI dv -^ @ .ae t o X 6 ,otir'rfiriuatfiryvrr'rnfifi 1n = 0.0029) rrasfiorrlrfiursironr:nolda HBv d.nuu z lyrl

io!r'zo{ugtil'lnlfrfranrunrvnao n"nr{un;iru6u r finrrrurfiu.rt,rU:srl'lsu l-3 rdrrfioruiuurfiuulr't

n-unulda rrritdfinlrruilnndl\r yt'ht dfr fi fi :s sr-u o . o s

$


44

t

2,3 01U

6n.ltrln 17ooa.o6l

I dn{ m'l rflrfi ni : c ri rl o'r u rTunr: f, n r fi olr :'t#rm"n r fl u fi tuunarn:

lt.ttu..|rnan.lunit Inti

0''ruI

oXn119to r uA HBV

6orf;o rifiorf;o

l?tl OR 952 Confidence

OR,{

20 - 24 20 30 50 1.00

25 - 29 35 49 84 L.07 0.49 - 2.33

30 - 34 42 24 66 2.63 1.15 - 6.02r

35 - 39 24 15 39 0.94 0,54 - 6,22

> 40 37 22 59 2.52 1.09 - 5,90..

r1N 158 140 298

i :.ililffiffi::T#lll ll, ll:l: =ll =u,1"": =ffi:l

runnr:fr nurnu'i r ors fi fi nr r u#rufiudn-un r:6r, f o r', r"adudn r nudu 'luuon1n5

I

1r,rnu1u'lnnlun.rrvrd: odrrfiriuarrirpnr.rafififi o.og'tduri rirrorg 30-34 fl (i =

0.019g) trils 40 flf,uru (p = 0.029g) unsfinrrnrfiu{il:curil z.b rrii rfioruiuu

s

rfiaun-undroru:su'irt zo-zq, fltt


45

I

62,4 A',ldil

6lufln{ n.t:;n r ila rsv aruarfl rmol tnarn:lt{ tfl'ltnafiult{ t nf:

a0-rdll

nr:fierta Hgv

otanru0 rri6o rfo

o-o:rnr:fio t $o

({ouac )

t'lrl

tmTn r r uvrln'l'lu6ts o

-lo

ufin.rrufiriru ruf;onutfr

31

31

4

2

18

31

31

6

1

1

2

25

33

2

0

15

24

38

2

0

0

I

56

.646

2

33

55

69

I1

1

3

55.4

48. 4

66. 7

100.0

54. 5

56.4

44.9

75.0

100.0

100.0

66. 7

I

u od a C

I e'luuln t fl nunn'15 tt l.lylu

et et d- a Cr e.l!ru-rn5{ 6lrr}rltu

et oAtq1ilu1nnulu'ln

.A

n?J-lu.lalnnun

r'lu'lu1fliu'lt!lc

[illIuo(yrugrIt{ytu

ovnun'ru'lNU

fidrun'unnyrvrti

t'lN 158 140 298

ETn'lrl{d te n;ilorfryrdr{ t fiqtsrun;iudrodrrfirfrrirulunrrfinurnErnll

.u6-utt-atolvtvovvluo(utn'1{nu 15u{aTlu Elnuou'luNlnlo9.tu ylunttnytu nun-ru'lilu llt-'r}ru-lyt:\tilttnnu ild'tuv ( et vi a f C a uA 6 eylu9[[v{14u leluu'llllylnuan'll]]flvlu lr}ryru lE'l}ru'lnlltrlu't6t }ru'lu-latytnun . y{un.t'lltyt"l

6'l1il6lso'lo minlrufrriT u rufiosrulrT rflcHu-rul;riurf,n o-ruillfru qc rfiu'irrioircr:mrtt1flil'Tu'lunr:fiot#o rriarmrnfilcu'rlrrrjiuurfiuun'l.rurlnnei'l.ruo,rnrrfrnrta HBv ld

A,4uol.v'6.o9uilc 1fi0r6lensirtiluo-st:1nrxfrolfio ({ounc ) esyruirorfir'rfifi0'sntn'l:6nrf,oar nrm:n

]


46

t

t

riu{ntsTuflnulnlilfiou ndr, 6o r{rrrirfi:'.rfiumd fiusrunyrti n-unrur.lTu unvrd r{rr,trirJ o C at o tfitnnfinnr:unvrrf {rirununrnvtu mJ'lu16rrnnfin nfinrrunln'r'lusruo'lrr r{rufrrfinururn

minr rufidru r r,tf, onutf uns mlrulniurfi n nrilnlo-u

r ioficr:ruleturun{ruohodrr rfiou'rlui r o:rrfurmuunnsittunrrfio r f,o

HBV 'lunl.lilfi6 r,nyirfi s nlruorf;vrfiorurinullui rn:rsrir,rrnmtunnst'l{u0{o'eti'lnliot

fiorflo loutflnr:n06l0u z-test rduri min.rrun'rrn'ur6tsaro nrinrru{drurr,tfionutflu et ) a a- 4 I - 6 tla'luu1vtflu'1u'l6t v{u1u.tn tvtnun lldsnu'lulnxdldfl u\tcEtl6lo{t^tanrri tn:rsu

d{tunr:r.tfi le dorufi

a


_...!-z

4T

t

n'rn{i 19. ustm?.r5rnr:irn:rsfin, rlunnirrratolamnrtfinr$o IIBV (p-vatue) tu

s niirorf r,mo{ rnar:fi { rd-ltnnnTnw r ndr

orfinoal

(09rT1n'l1gto ld0

ruilordr{oaas )

mintrun"t

n1"rN6lso'lq

( 55. 4)

ffinufiri,ut

rr.rfionutf

(48.4)

u etitq1ilu.tll

flu1u1n

(54.5)

lI?J'lu.ln

rmnfisr

( 56.4 )

v{u1ula

iurfx(44.9)

tmintruntn?-tn6tso'la (bs. 4 )

wr?n,r rufidr u r r,tfi onutf (48.4)

ct etiI E',il4u1ytfirj']u1n ( 54. 5 )

fl?J'lu'ln rnnfin (56.4)

nururniurfn (e+.9)

0,2266 0,4721 0.4562 0.1230

0.2843 0.1949 0.3409

0.4325 0.1814

0. 1038

C

,.nrlr'rod 19 tfioutdn:rnrrfiqrto Hsv s nriruorflfiu-lytg6tault'to1'lru,'

urrnoirrlunr:fiqrflo lnu{r.mnotouyrn 1 ri qun:u ro ri rsrurfl z-test ldud

ntintrunlnl'lruFts0'lo n-r*in.,'n {tr'u,rnf,oirrfl d.rfia'sr:ri'',r6m#o{orr, ss.4 rns

48.4 enNatfiu une,irronrundrwu'ir z orfindtniirrfi fia'n:rnufiorf;o nsv rd.-ivo

rrsrndr.rn"ufi:uouriuafn'rryn1.tf,fr4 0. 0s (p = o.ZZBG)

runnr:i,o:rrf ,lnr'lr'lod tg nao.rrfirfiu'ir f,sr:rnrrfio,$o HBv 1u b

nrirorfin rduri minrruvr'rox1il6tcoro Hfin{ru{rirurr.rf,anurfl r{rrafirfina'ru1n }ftJ'ru'ril."

tnnfin unsnulu'tnitrfln trifinnruuErnsir{rTufirco-uriudldrg o.0b (p > o.os) a"nriu1g

. c i Aon;iruo'rf,ndu r riufin:irudrotir.r riou r fiuru lriolnrnu*ruri r o:rc fyn{ dfrfild


48

*

2. 5 Xs Us tXnldyt't\t-lu1u15\t lnf'lu'l6l

AvvC.-oaflm:1{fi 20 llfln.|n11$6luru$rcu',r',r{rEus lle1n-rflm1ulu1t{rtrnmfl fTrnTnnrdo

lr{an'tn"n r ou fi luunn.tnilir! tg-rtnanAln{ t rd:

ssus t1n1finht-ru nr:fror#o Hgv

1u1l{r,ru'ru1n(fl) fiorf;o rd6or#o

:?N 0B 952 Confidence

-oR

^(4 37 54 91 1

5 - 9 39 38 77 1.50 0.78 - 2.90

), L0 82 48 130 2,49 1.39 - 4.49'

t,ril 158 140 298

. unnoi'l{odr,rfiriuardrg d o.os 1r, (d.f. = 1) = 9.94, p = 0.00161

{.q'rnnrrr.td z0 ruir uro'lnrdy't\t'ru1n1:{yru'rr'rou'lu#ond to fl#uru frI

nrrrurdu.rpionr:6nr#orr{lfiuo-nrdu fi u:cNrru 2. b rdruoroufintrrurioun'ir 4 fr,Eovuooi@

[[nsO?liltt9lnnl{UNlJUSllnrUnl{6lnn nluOU 0.05 (P = 0.0016)

fCopyright by Mahidol University

49

?

i - - .! o ( . -t . a o A I _- u o o 6n151{n 21 [fln{m1$5lrltu65cr1'l{:1u16n0tnounun'linntiolr*fnUonrau u

'luu0a1n:1:{ ttrJtulnnl|lfirt I MTt

trulfisio r fiou nlrfio,ffr rru

6q r #o rrifin r #o(u'rvr)

95X Confidence

ORa

( 2,500

2,500 - 5,000

5,000 - 7,500

7,500 - 10,000

> 10,000

23

91

31

9

4

26

93

L4

6

1

49

184

45

15

5

1.00

1. 11

2.50

1. 70

4.52

0.56 - 2.19

0.99 - 6.39

0.46 - 6.44

0.40 - 4.52

11il 140158 298

I

a1nn1rfrnBrtfiurfiu:ruldpior6ouzotunarn: nu'irndufifir'luldeior60tl

rurdurrini'r 10 ,000 uryr 'firrlu,;iou

orn.,I

^96.srordo HBV f,{rflu e.s rdr uns 4.b rdr zotn;ir.rfifi:ra'tsir?oun.ir 2,b00 u-ryrllj.9'alruilldu ustnrrilronstr,r flrrilfiriuCIrrirgvrr,r afififi o. on

{


50

J

adnTl{n 22 u.tn{milf,rrt#:su'irrr'nnmminlun:arn:-rfiunr:finrfr ot.t:-dn-u

o-nrflu fi trrunarntlf{nulmanlttrl rfiti

qlu'luRmfin1u

aiouFtt-'l

oXn'l:gt9ttd0 HBv

oXgto I ilo rri6nr$o

95% Confidence

OR

:'ltl

{

<4

4-7>,|

85

39

16

103

41

L4

188

80

30

1.00

0. 87

0.72

0.50 - 1.52

0.31 - 1.67

5?U 158 140 298

e'lnn1i fi nmfiu'i'l q'ur unrurfi nlunrounir trifi nr rdlfiudrTunrr 6-o r #orr {n

+ Fr-uo'n r ilu fi luunnrnilr{ r{rJru'lnn'1lrshu nu: firs durium6'rgnrr afi 6 o . o s


51

;

z,I qturu#finutdtupr:ounir

,'rr'roi zs udnrnmr#rf,r^d:;uirrr'rutlfifnru'ld1ua:aun:-r n-unr:frartalrtdn-u

o-n | ilu'luunnln:Ir{ rc,Tnnntrni! r rdi

qruru#fi:rurd.

1un:oun{'r

oIn'l5grold0 I{Bv

o8,aE9r0t t d0 lNgro 1d0

95% Confidence

OR

t?tl

..1

45

73

22

11

7

36

63

19

11

9

81

136

4L

22

19

1.61

1,49

1.49

L.29

1.00

0.49 - 5.39

0.47 - 4,76

0.40 - 5.57

0,29 - 5,73

296138158:,IN

IE'lnnttAnu'lflu'i"l q.turufifi:ruld1un:ourl5"1ua\t uofl1n5 trifiorrrufllrtrudnlu

u,oln15 60 r fl alr r-Rrr'uo-n I du fi fi :e duliu il'16'ru 0 . 0 b


52

1}

nTTln 24 uenrnrrrf,uffid:rrirrrrlfruo{nrorniria r frau fiunrrfu rflorr{ndu

a"ntilu fl trrunnrnilt{rg.ttnannrfr{ tnti

Ial

ttul6nrounr-r

sior6ou

nr:fiorf,o rgv

6nrf,o rilfrorf;o

952 Confidence

OR

t't$

.if.

< 5,000

51000 - 10,000

10,000 - 15,000

15,000 - 20,000

> 20,000

42

83

11

L2

4

2T

67

28

t6

3

63

150

39

28

7

5.09

3. l5

1.00

1.91

3.39

1.9.6 - 13.46"

1.38 - 7.32r*

0.61 - 6.03

0.47 - 26,32

tjt&t L52 135 287 ( 100 )

+ ' unnrirtadr'rfiriunrfiqfi 0.05 112 (d.f .=1) = L2,Tgt

" rrnnsil,rorir.rfirbardrufi o.ob [xz (d.f .=1) = g.06,

e'rnnr:finurwu'ir niilgnarn:firrutfin:aunr-r7r6ou r?oun,ir 5'000 u-rylt9^-^--"r-.ie.---,-9 - . - o d r o Illnsndelvlils'lu-lo t8lt?l{ 5,000-10,000 u'Ifl Fo't'tNr6lu.tgr0nr:60tUa ngv n{nirniiut-01Ae-,--tr- . afrfr:ralftsuirq 10,000-15,000 u'lvt fi.r s.og ilils 3.ts rfir nrilnsiu nnsfinmu

rnneir,iodr.rfiriunrdrunr,rnfifid:sdu o. os nru{un{rufiu r 1ilwu'irfintuuonsir,rodr,,rcts o AA D. . ia b tuiluu6naarm{flnn ufinun;irufifinurdorouni'?ilrnn'ir eo,oo0 urn qsfinmrurfir,{ria

ol. ,t, I

nr:fiotfro HBv d't tilu g.gg rilraotnr!rufifi:rurd:sra'irr 10,000-1b,000 unylt .l.e,

uemrru r fru,r firilfinrrruusrndrr fi:r fiufrumdrg o . os

P = 0.00041

P = 0.00451


53

a

i

;-us€..trt;.9n-li-t{fi zb u5ln{n'l1r6t*$fili:cH'ir{n'nIuri'tfrlq1! rtiln niunr:frnrfal'li"dn1la"n l6lu

fi tnnarn:l:rr rurtnnn'uft{ I tfdtI

o8nt5grold0 HBv

6tc'ts tnon 5'ltl OR 952 Confidence

6srr f;o rr,i6e r #o

Ud2.lo uu'lytu5salat2.10.1 litls tnon

vfl 56 61 ll7 0,7t 0.43-1.16rrivrr rcz Tg 191 l.oo

5x1f 158 140 298

flnn'nfinmmJdl nrtfirarirfi r a1s r fi0a?,0{ unn'lnilrifinrruf,rurtudriunr:fio r f,a

r. Hsv fi:sduriuordrg o.os

C


54

'

a2. 10. 2 flnu'l

mrl{fi 26 u.ta{nlrrlfluftdrsu'irrnrrfiilrhdfl*'t n-unr:6nrf;oltidn-ua-nrau fi

'luunn'lnr1l{ m.ltnnnlult!| I }rd5

Baou'l

o8nlrnqrd0 ItBv

fior$o rri6or#o

X'lll OB 952 Confidence

ORd

?t"l 74 7l 114 0.96 0.53 - 1.39

rilvrr 84 69 1b3 1. oo

:'lN 158 140 298

qrnnr:finurm.r'ir nr:fir,rfirfif;oar rrifinmruflrufrrdfiunr:fior$o HBv 1u

unnrn:li'r uururanlulr{ r flui fi :c fiuriuatn'rX o . o s

a

I


55

I

2. 10. 3 yl'1[tHn

r 6tn.t m 1$flurird: c ri rr nr: fi ufir fi nrunaniunr: 6a r $a1r r-ila-uo-n r au fi

ltnma'lntlirr fiultnnnlllfr{ I ffi :

vt*tttrua

oIntSaoruo HBv

o t ,a llao I u0 'lilgto r d0

T'tU OR 95X Confidence

OB{

?f-l 22 6g 140 o. gg 0. 55 - 1. 44

tilvrr 86 Tz ls8 1. oo

a

51N 158 140 298

a1nn1:frnu'll'tu'i'l ntivrlrrhrfl rrifiorrruflrftrdrTunr:fiorfrot,:-nfiuo-nrilu fi 1u

uodln:li{ nulmnnlttilit r ]td5 fi:s oiuriadfrr'rg o . os

lCopyright by Mahidol University

56

?

&ad2,10,4 n'n[un, uu t4509n?e lfloq

; _ vuc , 4ui & a . u o I' n-|5Tn 28 $5ln{n1lIdum5lcl|?-l{n'l:iltM1nuUn, ilu uSan:retion n-ttfnifulila

lr{tn'uo"n rau fi tutnn-ln:1i{ru1rnnn1ulN lrfiiI

&aoIt[un, uu t4t0 n'15oolt0 HBv

ataao:lE rfroo 6o r f o rrifis rita

51N OR 95% Confidence

OR

{

yf"l 2L 13 34 1.50 0.68 _ 3.32

tiyrr 1g 7 tzl 264 1. oo

5',lil 158 140 298

elnn'l56nu1flu'i'l n'ltrun, d'u uionmerfioo rrifin?lu#ilfiudriunr:finr#oa

HBv luunn'rntlt\r l{u'lu1on'lrr?t\t t nU: fi:s fiuriuAfnriq O . O S

dT

1t


57

]

ao2,t0,5 l^l''1910

rg

nr1{$29ufl n{n'lrf flrfrrd:;u'irrnr:ffi ft nnnn-rnr:f, nriiatrt-fl n-lto-nrdufi

'luunnr:1: { tcntnnn.luril I nill

a tr 4t. on'tlNt4u']vrll't9ro

nr:6or$o Hsv

fior$o rrifior$o

5'lll 0R 952 Confidence

OR

I

?t'l 2L 4 '-6 2.79 0.82 - L2.L4

lrin-r 146 136 ztz t. oo

.e . a cti ' . o I 3qlnnrifinurm.ril nrrurauryrn.rHrsr'n finrurfis{nonr:fiorto HBv il{ rfru, . J , tct et A . o E,ro. I

z . I r firuo,r nrirufirdrdiirarirfinrsrroio uErnmilrsrnn:.r frrrifiriuardrgvrr,r nfififi o . osI

I

.J


58

?

2. 10. 6 n',l:Y|']a6l09l '

iuotlraaioatouo6n151i!n 30 U6ln{m1$61$fi}r85sil',l'l{n-|tuuu'lnn.lnaan nun159nluol'ltdnuanl6lu il

'ln nfl1n515\t tw.ltnnnlutN I ndtI

6ynl5$totd0 HBV

dudtll,tu'lytnlan0q

fio rto rrifio rf;a

5Xl| OR 952 Confidence

OR

I

vf"l 14 10 24 L.26 0.51 - 3.19

rrivrt 144 130 27 4 1.00

:'lN 158 140 298

elnn'rxfinu1nu'i'l nltyt"lrt6toorifinnruf,lftrdn-unr:fin I f;otr:-Rduo-n r du fi 1u

unn'lnilt{ rru'lu'rnnluw\t r t{Ui firu fiufiudfrr'rg o . os

t,

I


59

?

2.10.7 n.lln.llfu

unnr nr r uf,if,ud:; u'i rr nr: fi u*riinrn fitnr: f, n r lo tr ian-udn r au fi

'lgunn'ln:1t{ tB1tnan'ut|\| I fid5I

r,rfirfivrrffu

oEn'l:Ft9trd0 HBv

oXral9r9r I U0 lNno 1d0

:'1il 0R 95X Confidence

OR

1

yt'l 4 1 5 3. 61 0. 35 - 1?9.06

lilvr'r 184 139 zgg r. oo

1?lI 158 140 298

r vir u o t n d rufi rilrdfi r,rrir finrfiu

qrnn1ifrnu1m,'i"r nr:fir.rrirfintfir finrrurfiurdonr:fior#o HBv ft',r rflu g.oa

uerinirrunnnsiru fr rrifiriunr6'qnr.r afi 6fi o. os

a


60

t-

,,,2.10.8 a51EnU1?J

nTi'l{il 32 r6tn { n'r rrtfrrfi ^d:c u'i rr nr: fi ufirfi n: T enu'l fln:r,nrr f, n r $a tr faf,rn-n r ou fi

trrunar5l:{ tcj.ltnan'luri! | fld5

a6

an51AnUlU

oBn'llgro r d0 HBv

fiq r#o rrifio r#o

:'ltl OR 95% Confidence

OR

^n"l 26 22 48 1.06 0.54 - 2.05

lriyr'r Lgz 118 250 1.00

51il 158 140 298

emnlrfinurnujr n,tren'rqnu'tfl rrifinmrudlfudrTunr:fio r totrr-nsr-u0-n r f,u fi!

luunnrntlt{ stu'lu16tn"l[H\t 1fidi fi:u o-utiuRlo'rg 0. os

.a


61

f,

2.10.9 yt"l0'l'lN6lEo'lo, lnuuuc

mrl{ fi ,BB lr6ts{ mrf,irrfod:c rirt nr:innfirfinrnrlut! o'rn, r fi wu, n-unr:f,n r $o

rT itfir.rf,nrau fi tuunarn:rrrrorrnan'rum rnur

yrln11u6tso'lo, nr:fio,$o rru

d6Y.aYlnuluc 9toruo lunorio

5'lN OR 952 Confidence

OB

a.

lt"t 39 3g 77 0.98 0.51 - 1.53

rrlvrt 119 Loz zzL 1. oo

r?lj 158 140 298

qrnnrrfinurnu'ir nr:frrlfirfin'ml1ldc o'ro , r fiuuu, rrifisrT rruf,ufiudn-unr:fioX j s u -ordo HBv vr:s0uuu6l*|nru 0.05

{

f


62

t

It u A 6 . q C^ Ir oro2.10.10 tnunl{ ra:0{&t0il,taq, r1n6t0n, aun:ftf1uuo{uE 6n1r

-.!o€.6tl;6ttaa.uuiln{ n'l't$6lltr{u6:! tf'l'l{ nlt r|uu'tn I ntn]t r n-a{ Iothnn, nlnaon,

qrlnr nhufr .r ufi fi Hn rr dunr: fi n I $otr :-dn-udn r du fi lnl-nnrr

ft{r,ct.ltnnn'utN lfiili

a

duia.uolInun'l{ [450{$0il']na, n15ootf0 HBv

n*lnnoo, QUnrrfifio.r

ufirifinr: fio rflo ril6o r flo

5?N 0R 95% Confidence

OR

Yf'l 50 47 97 o.g2 0.55 - 1.53

friyrf 1og 99 zot 1. oo

5?N 158 140 298

ETnrrdnrrvwil nr:firafirfi r fiu#r,r r ndor frodrsr-o , tt"nnoo , ounldfio,{ uAfiH

I -- 16 u o (s o X o o v d Inll trtfiorru#rufrudn-unr:6ottohiYilajudnrau fr luuad'tnt1r{y{?J'lu't6tn1ttv{.nlrd: fiI

:uduriuatdrp o.os

e

I


63

t

z. 10. r1 tsdrrfrr,fior,flo,

"'tt.ofi gs uan.rnrrrfiriiuf:crirrnr:innhfurflrrfrrtourfian n-unr:f,nr$ot'r:'il

nfua"n rilu fi tuunarnrl:rffirmanlttttl t rdi

us#r.rrir r fiau, f,0,

nr:fin,$r rru

fio,#o fi6qrto

5'lN OR 952 Confidence

ORA

vl'l 19 19 3g 0.gg o.42 - 1.84

trlvrr 87 tzt z5g t. oo

i1u 156 140 298

qrnnrrfinurynyir nr:us #rr ffr r fiou, f,oo rrifinmrutlrtudffunr:fio r f;olr:-aoTu

dnrRu fli tuunnrniltitltu'lutnn'l[n,i tnu: fi:sduriua'rdrpr.rnfi6 0.0s

,{


64

a

z, lo.Lz oNul6tflurlnclailioytrl rfiurrulq

iuul .'nr1\tfi gG rfln{m'lufluftrdrsriTn-nffifirfrur6tau unsldfionrlrf,unu1r n-u

nr:f, n r $olri-dn-ua-n I ;tu fi lrn narn:l:{ ltu,llnnnlurl I rdt

oriulflnuuilsfdrio nr:fior$a Hgv

yn{ rAuu'rule fior#o rri6or#a

:'lll 0R 95X Confidence

OR.a

yf'l g 3 11 2.47 0. 5g - !4,70

rrivrr 148 1g7 285 1.00

51lf 156 140 296

an'rrfio r f,ol'r:-lfiuo'n r du fi r fru

ooiyt1\t6lnnn 0.05

ernnl:finu'lmJ'i'l nr:fi r,trirfi nru-r;rru rng ldliam{ r huurule qc fi nnru r du{ eio

z . b r iruor nriufirrjrdnl udonuronrir,r firrjfiriscrriru

{


65

a

A I vl2. 1l n'l:grotuoll1nffi1N{'lu

-ll-

nrri sz u6tn{nrr!f,rrhrd:erirrnririd?Nrufinr$a Hsv niunr:hnr$orrr-nf;u

o'n rau fi luunarnilt{to1u16tfi[N I ltui

et. o XH:1N{1U9t9ild0 HBVI

ofln'1500 r u0 HBv

'oorf;o 'rilfrorfo

l?ll 0R 952 Confidence

OR

i

lrifi 4L zg 70 t. oo

fr 4g 4L g9 o.gg o,4z - !.64

lrin:ru 68 68 1g6 t,!7 0.66 - z.o?

I'lu I57 138 295

mnn.r:flnu'trru'i'l n1rfi fiti{'ru{ lu6o, $r Hgv u5onr:fi'trin:ru'irfifidrrur rufi oE^.rdor!tto ttgv r,riorri uifirrrrruffufiudrTunrrfiu,#,,ru 1uuofl1n:15{rr?J'nn6rn"rilH.r rHui fi|

. ..rtr. r

:uduriuotn'rg o.os

{


66

t

2,L2

tai q u d 4^ .! v- a - v o 6 Iml.t{tl 38 l|fln{tr1'luflun5:cu?1{fr1'ruRlun15alrH]6lt-anmrFt'luu{ dlnr:Hnrf;o

lr{afruo"n t gu fi tumaln:'l:ltu-lrnnn'un rrtt

nrufilunr:

fllriarfioo

oIn'15AOtto HBV

t?ll 952 Confidence

OBonoort0 rilfior$o

{

lirsrud,

nn IoouI

otvln6luolltt

uInlUI

44

6

59

60

16

6

68

39

60

L2

127

99

1.00

0.36

0. 32

0. 56

0.09 - 1.52

0.15 - 0.65.

0.26 - 1.19

298169 L29:'lN

T

, ttnn9i'l\r0dr.rfiriunrfrffi 0.ob lxz (d.f.=1) = 10.84, p = 0.0010]

qlnn'lrfinur t fiurn-u n'ltf,-Ntiil r f,oonrlfur,rril ruir1un;ilfifinrrolrrin r fioorn

n'uorri finrrrurfiu.rsionr:6qr#0 HBv riaun'irnrilfitrirnun-lrTarf,oo otir,rfifiootd'E 1n'=

0.00101 ttoid'ttt:'un{ru6u r 6o n{rud#un-d4n,drur$orn'r-uriu emrrdursionr:fiorf,otriI I t -r''-'---' , J--, u v a

9t1\t Q',lnnStNytlu I auflNt^l6l 16t0gl

a


6T

t

z. ts nrrufrrifir,rf,.rern rfiour f;on

r'rt-rofi gg uanr nruf,rtfr fr: ri rr nr: uffi ua-.nrn r ilou r fi o n rirnr: f, n r f olr r-f,

frua-n rdu fi tuunarnrli{nu-lrnanlurN r fid:

nrrUfirifiun'.rqrn nrrfior$o Hgv

r f,ou rf,oo 6n rf;o rrifio rf;o

l'l1l 0R 952 Confidence

OR

a9, oan1{ytun 41 33 74 1.00

ttrlrl6tltlntuqn]iil 6T 6g 135 0.79 0.43 - 1.46t-.-eattnt\t1uoo[6nqchtn1{ 27 21 4g 1.03 0,47 - 2.30

t?N 135 122 257

f

qrnnr:flnurruir nr:ufiri6uii'.rqrn r fiou r fioo trifiorru#lr1udrTunr:fio r f;o

1'l :-fl a-uo'n r au fl luugtotnt It { y{?J'lut6t n10 n.t 1 r{d I fi : u n-uriu nmlrgn'l { fl fi fi o . 0 b

I


68

t

a3gai2,L3 rnoo tUOu[5l0Ft1fJr,n0 [050{rtuu

i - ^ qb( . aa E- X a i ! a fm:l{ n 40 uflo{ n'l'lll6lrm.t55c r1'l{ n-lr$ l nan I ilou r alonnur5o l n5a\r ttuunun'li6n I d-a.t

1r :"gdua'n t alu il 1uunn1n51:inc,-lu1nn1[fi\t r ndl

rfioorrfiaurHoonru,

aaI 050{ IUU

Itadn'lxgror?t0 HBv

A3,oy9ro I u0 lilao r d0

95% Confidence

OB

51il

4Itrd

IurU0ila

nn IqouI

u(y|niluo1r4I

g

fln?ilI

24

I62

27

18

6

69

L7

42

L4

131

44

1. 00

1.00

0.67

1. 19

0.25 - 4.01

0.32 - L.44

0.46 - 3.09

231

a r cta g E a iE1nn1rfinu1ytu'l'l nt:N t noa r uou r 6t0rrilNlr:o r Ft50{ uuu uifiorrruo'ufrudffunrr

,tfrotfiolr:-ao-uo-nrilu fi lugnnrnSl:{}ru'1u-liln'rrrfl\r rnu: fi:urTufiunrd'ry o.osI


69

t

2.15

aN1:Til 4I

2.t5,1 n.lrYtlfrr

uanr nrrrfirfrrd:cuirrnr:'ld:-unr:nTfu niunr:f,n r f,a1rr-fln'u0-n r au ii

'lrn n6t'1n515{ td.|tnfl natn{ I fiu5

tnr:vrn{u

|,,

1e'urunr-t;

oXn'l50t9t ld0 HBv

oXaqrd0 rrifinrf;o

5'tN OR 952 Confidence

OR

0

1

2

3

5

49

65

3

II

43

62

z

2

0

92

t27

5

3

1

1. 00

0.92

1. 32

0.44

o,52 - 1.63

0.14 - 16.40

0.01 - g.7g

t'tN 119 109 228

qlnnrr6nb'lfltu'i"l ntrdunarn:1d:-unr:n1flu

lr :easr-udn r ilu fi fi:s sr-ufiun1,o'ru o. ou

rilfi nr uf,irfridn'unr: fi o r #o

_i


70

I

z.ls.z nrrld:'urhon

Ianlr.l{n 42 unar nr ufluftrdr s ri rr nr: ld{u r $a nfi.t { }rno n r io nnl niunr: fi n r $0 1r :-f,ouanuonrdu u lurinn.tnt1:\tltu'lu-ldn1llfi{ Iild:

nr:lfr:-urfiosr

aad

nlt0tordO IIBV

6qr$o rilfrsrrf;o

51U 0R 95jt Confidence

ORa

lfr:-u zo s zb 8.94 1.g4 - 12.39*

rrir#iu 1go tzg zss 1. oo

x'rN 150 133 283

uonsirrodr.rfirianfdrU fi o.os 1x, (d.f.=i) = 6.g8, p = 0.008?I

qrnnrrfrnurnu'ir nr:lfr:-u r fion fiorrr, firocotunr:60 r f;orr:*asr'uo-n rnu il

( 'roudn{rugnnrn:dt6:-urfionfitonrnrdu.rsionr:6or$o Hsi urcurru a rriruo,rn{ldrrird

{urf,oovrr,runootf,ooo't rncfinrrilf,ilfrudorir{filiuordrynr,rnfififi:ro-u 0.0s ',,

=

0. 0087 )


71

|

ttg . 92.I5.3 n1:'lotun15r{-lnn

)nu€.uo.suJm:'l{fi 4g u6tn.rn'r'rrfr$frdrsri'Nnr'tf,:.unr:r.irnjn rlunrrfiniiiol'l:"dn1la'ntau fi

'luuna1n515{ rBTrnn"urit t }td :t

nr:16{unr:ritsr-o nr:fror$o Hev

lelurun:-.t; fin,$a rri6o r$o

l1X OR 95% Confidence

OR

{

0

1

2

3

4

91 95 186 1.00

46 30 76 1.60 0.90 - 2.86

T 4 11 1.83 0.45 - 8.78

2 2 4 1.04 0.07-14.68

011

:1N 146 132 278

|t

Ernnlrdnu'ryluix nr:ld:-unr:sirdo trjfinnuflufiudffunrrfinrf;otr:-ao'u

o-nrilu fl luunarnSli\ty{u'lu16tn1[tr.t rnt: firsdu o.os


72

t

A.u2.t5.4 n1519t5un15U6t$Onn!!

a

nr1{fi 44 uanrnrrlflirtrd:nirrnr:t#iunrlnunon ntnr:f,n r$otr:-aflua*n rau fi

luunnrn:Ir{ lsltnnn.lufi{ I fidi

[email protected]]o:unltuoNonn n.lx$rordo I{Bvttg

(almuni\ I 6or$a rrifiorf,o

l1I OB 95% Confidence

OR

I

t26 121 247 1.00

r 20 11 3L L.75 0.76 - 4.08

2 L L 2 0.96 0.01 .- 76.00

3101

l',lN 148 133 281

a q"rnnrrfrnu'rmJ'i'r nr:1fr:-unriuFrilonn rilfinrrlf,ufiu$rTunr:fisr r $orr{asr'u

dnrau fi luuonrnrl:rmrrurnn'lrn{ rm: fi:sduriunrn'E o.os

?


73

+

2,L5.5 n'ltonoouFtlI

.,m:T{fi 4b u6tn{n11r#rriud:euirrnrrnaanlni n-rnrrrf,nriiolridnln-nrau fit

luuffatn: li\r tw'tmflnlurt{ t '|dtI

n15fln0oua5I

.t,

(a1u1un5",it )

oInl:aorflo HBv

oIoorda

.ag1N0r0rd0

51tl OR 952 Confidence

OR

0

1

2

3

4

98

34

13

2

2

99

26

7

0

0

L97

60

20

2

2

1.00

L.32

1.88

0.71 - 2.46

0.66 - 5.46

x1&l 149 t32 28r

q'rnn1ifinu'lfiu'i'l nrtnnoouet: ilfio.ntflrufiudffunr:fie r $olr:'tduo'n I ilu fi

'luuon1n:1i\i mJlu'ldn"lltu,t r fldt fi:s o'uriudfdrg O. 0SI


74

*

z.t5.o tnfrl,tri,r

jooS.DroaoAmi1{fi 4G u6ln{n'11$61'rfruri:crirtnr:16:"tnr:a-nfirufitriunr:fiarfio1,:"f,n"uo'nldu ii

1uuna1n515{ l{ulnanarr{ I }tt:I

nr:fiorffo nsvUAO

n'l55lnr,t'tt4uit

oSrAXaord0 lilaa1d0

:XN OR 95% Confidence

OBd

#n g z s 1.Bl o.lb-ls.ggrrif,n 1bo 191 zgt 1. oo

t?r 153 133 286

elnnrrfinu'ly{u'i1n1:ld{unr:f,nfirr,tri.r'trifrnrrruflrffudrYunr:6orf;orr:'f,sTuo-n rdufi

luunnrnr lT ir $tu-ru1iln1rrn,r r rryu : fi :s fiuriuarffrg o . o s

I


76

+

2.t5.? n15n1rfr{

ffi tn{ n'r rufirfi d: c u'i -rir n1r n"il ft frunr: fl n r f, o1r :-iln-ufin r au fi

'luuffnln:It{ ltu-ltnnnTlr{ I iltt

nrrnlufr

1rru.u.oi 1

oZnl:aord0 HBv

o'Xoqrd0 ru6o r $o

OB 95% Confidence

OR{

0.19 - 8.14

1.00

l,L7

278

7

130

3

0

148

4

1

0

1

2

51ru 153 133 285

q'rnnr:6nu'l$u'i-r n1lyl"tlrff{ rrifinrrlflrufiudn-unr:fisr$o1r:-no'uo-nrflu fi .lu

I Urrd"lnili.l nu'tu')iln'1lrnit t fidt firs d'ufiunfah 0. 0b


76

I

2 . 15 .8 n15 I ll',ls t4!

iooa.rtosatooo6n.ltliln 48 $6ln{m1r6lUfil{fi:su'l'r{n1i'latufl-r5]lllrunun.|1nnrd0l'l:6lnrranl6lu u

t

luunarmli{ rEr'ru'lnn1tlfl{ r fid:I

nr:fiorf,o Hsv

n1t tqlBu!

frn rf;o rri6s rf;o

l1N OR 952 Confidence

OR

t

lql8 47 55 I02 0.65 0.39 - 1.09

tirqrc 103 78 181 t.oo

YIN 150 133 283

ql n n.rr fi nurrui rnrr ld{u n.l: r q'r s u rrifi srm udlfudrYunr: fi e r $o tr iRdua'n r du fi

luqnarn: l:it stu'lu'lnn*ufl{ 1 ild 5 fi rs rr'uriuarn'rU 0. o s

a

]Copyright by Mahidol University

77

?

2,15.9 nlNl:O

ad

n151{n 49 uiln.r ffllrfirrtud:e uiT n-lr r nu r fiunrrl:n firnr:f,n r $o1rr-dn'rm-n t au fi

'luunn.lm 1:{ ta.|tnanlllr{ t firf tI

nlNIro

oEn'lt00tf0 HBv

6o r #o rrifiq r f;o

51l| OR 952 Confidence

OR

a

lnurfiu 5 3 g 1.46 0.2g-9.60rrirnurfiu 148 tgo zTB 1.oo

5',lu 153 133 286

slnnrfinmsuil n']r rFru rfiunrrul:n rrifinmufuf,udn'unr:fin r$ot'r:-dq-u

dntnu fi tuqnorn:irrm.lrurnnlr$tit rr{u: firsduriunt6'rx o.os

J


---

78

?

6n'lt'liln

z. lb. 10 nrtld:'unr:tairionr.r tfiuuru'tE

unm nrrrf,irtrd:c u'il nr:1fl{tnr:rdrion'rr r f,rnnstcn:r,nr:fi n r f, all:-a

fim"n r ilu fi tlrunnrn:lrrrarrnnnTrn l rd:

t;iriovrr.r thuuru'lq

oIn.l:aotd0 HBv

6orto rilfior$o

95[ Confidence

OR

I?N

..

lau

tri r nu

2L

t28

t2

118

1.61

1.00

33

246

0.72 - 3.66

x?tl 149 130 279

ernnr:finurruir n",tfigu.'tnrrnuld:-unr:'ldilonrtrduilru'le tdfinmu

#ruflrudrTunr:fin r fforrfaduo-n r ilu fi

0.05

luunn'lnili{ y'ttj'lu.tnnltt$N I ]tdi fi:uo-ufiunmiqg

{1

I


79

?

z,Lo,1 $rfirurflrrflruyruflrfrl,rri,r

n1:1{n 51at

uaar m ufrrlftd: ; u'irr nrrt#iuafi H r unnn r f; rrun r firfi r mi.r nlnr:

z. 16 nr:ld:-uorifi [ usrlu't'luuig E"l

f

fintfalr:-nn-ua"nrlu fi

t tt

lurmnrn:I:{ rulrnstnTli{ l ndtI

4 -u tt ItI UU'lutt6t',t tlytit t u'l

A!illl4lr{

oJn119to I dit HBV

oX9lo r d0 'tri6orfro

51$ 952 Confidence

ORa

lnu

lirnu100

35

113

40

213 0.'99

75 1.00

0.56 - 1.73

5',}il 135153 288

ernnrrfinmilu'i'l nr:dqnarnl t nunn r fiurflu#r uyr.r r flrfitari',r rrifinnrduyiud.uriunr:6orfioltt'iln-udnrau fl luqon'rnrl:\ryfJlutnnlttfl.rrndr fi:so'ufiufi6'ru o.os


80

j

66,66lz4d2,t6.2 r0 tUu[Na?tnBn5?Qtfl00t,|50n'l{ tn50\ttta

;-qu3.J.6-aa?,mr.|{n 52 udn{n?Tt6l$nr6:!u.t'l{nTmnfl'lntuo ltnltlHarnEn:'t!iliannSairlI

Saoa!-ou.tlffia{la m,fn:nn tuol?t3lnr,on tilu u luuna.|n:1:{tsTnanlurl| tfld5

iro rfluurrn

nr6orf,a nsv

otgtotuil rri6orta

952 Confidence

OR

OR

a.

rfiu

rrlrfiu

53

82

60

93

113

t75

1.00

1.00

0.60 - 1.65

28813515351ru

d-riaa-6ttala.6E',rnn1:6nu1y'nj11 n'l:ytu06t1nt$a I UultH6tutw n51e I iloou5aa'l{ l05a\t n0 ]ilfi

a o €o o t a 'o?rruf,rurTr.rriniunrrfio r floltt-f,n'ua-n r f,u fi luuonlnrli\wru'lu16tn'lttfi,t t ndt fi:c dutiu

n1fiq o.os


81

?

6' . Lt . 6 a2,t6,3 0U0tununBrulne'lntsn nnluilnn:o

u 6[n{ trr rufr$f,ud: c ri -w n]ro n1ufi sni nz nr rhf,n nlunrr fi n r torrfadu

0"n l du fi tnnarnt1:{lcl-ltnan'urn rrfd:

oXn'l:oolda HBv

6aooua I ugtutw r,t'lgt9ltl OB 952 Confidence

ORoflnoluil rrjfiorf,o

A

tou

lri rnu

32

256

18

135

L4

LzL

r. 15

1.00

0,52 - 2.57

5',lN 153 135 288

q'lnnr:frnmfiu'i-l n'trldiuorifi rr,rnunerirn'o tdud nr:nnlufionio trifinnru v (u o n

I I t ,

#rufrudn-unr:6orfiotrftdudnrau fi lugonrn:15{m,'lu1nn'rrn{ nrdl firud'ufiuardq

0.05I

a


82

?

z,L7 nr: 1frnr: r-nurui o nururn urifiilr u 6'uo'n r au

uam nmrfiufodr s rirr nr:'Ifrntt:-ntruiarurtnnuri$hufi.rdn t auriu

nr:fin r f; arrr-dn1n-n r f,u fi tumarnrli'r rulman.t$tt.r r xdi

In155nU1ltu',lU'ln

'.At. u vrlnHulunuOn r ilu

!

oIn'lrnqtdo HBv

oIno ru0 rrifrs r$o

952 Confidence

OR

5'lN

a

ltrnu

flns l-z ar\

flnr g-s n{,t

flnc o .{offur,t

nnr6au

triuduou

26

I7

3

2

5

104

42

24

25

20

l7

130

51

31

28

22

z2

1.00

0.86

l.l70.49

0.40

1.18

o,34 - 2.L2

0.41 - 3.25

0.09 - 1.77

0,04 - 1.93

0.34 - 3.93

28452 2325',tN

I

fl nn'rifinsrruirnr:1ff nr::"nrrmruraft hsn'uo'nrilulrifi nnrffrufiudn"unr:

6n r f;otr:-nn'udn rnu fi fi:cn'uft,nt6'E o, os

uaot'ir nr:lfrnr::-nu'uftJ'ru-rnuririurufruo'nrf,u tirflufle{urdurdonr:fror$o

1r fd gt'uo-n r nu fi 'Iuunnrnr lx { }tu 1 tnnn'l[[ fi \t I fl d x

?Copyright by Mahidol University

83

(t

d A OA X2.18 n'ltrj6luldn1uFnount'lnnlda HBv

mi1{i ss uitn{n'lrf,rfirdrrrirrnr:fifiarn8ntun:am:-rf,nrta my nitnrtf,nrto

It:"iln-udn r au fi ruuna'rnrlrir ro'rtnanlttrn r ilu:

'a I o !n15nnlu0 HBV. n1l00tda HBv

'tu6tmfinoionrri-'r frnrf;a rrifrqrf,a

l'llJ OR 952 Confidence

OR.J

uifi 44 zoz 246 1.oo

fi 7 24 31 1.a4 0.49 - g.bg

ttn:ru E la 18 t.TT o.E2 - b.69

5?$ 56 239 295

qrnnr:fl nurrruir nrrfinurfr nlun:ousfrfro r $0 HBv trlfinruffl$iudriunr:fio

a lr.ir fl o tr :'46'udn r au fi fi rc o'ufiu nroirpnr.r afr fi fi o . o s

aCopyright by Mahidol University

84

z.Ls ruo#rurtud

tv s I2. 19. 1 nflNnugyl'.l\l nltl

o

mr.r.rfi b6 u6rn{m1rf,$ftrd:grirrnr:fi rnnf,ifirdrTrnr:finrtorriafi.n'nlflu fi

'lurn6t'ln:15 i! tu.lu.|nnTtr{ t nUtI

aoo(N t srFl6ltjv{l,tD

nrtfior$a Hsv

o8.aYgto r drl 1$oo l d0

952 Confidence

OR

OR

.doot'lN r FruN riltt6lilyM6

d9l lrfl r ou?ng

str{ rflotun\t510\l [firl

38

3

113

0

6T

0

72

1

95

3

195

1

1.00

Undefined

2.35 1.39 - 4.03'

0.00

5XN 284154 130

' uondr{orir,rfirhtalfrrg 0.05 [X2 (d.f.=1) = 10.39, P = 0.0012]a

dvl

crnnlxfinur$ru'i'l nr:fi r nrt#rfnrdrTusir'r r nd finmrflrufiudn'unr:fio r f,ah:'oi u .t . .lq - v 6a a i . A Yfiud'nrnu ti odrrfiri?,ordEnr'r4fifi 1e = 0.0012; unufirrrurfiurdonr:fiorfio Hsv

a.r rflu 2. BS rfir ua{n6irufitliroufi rnn#ruftid Rta:-urun;iuduotl

trifi nn ru u srnsir{ nr'{ nfr fi

- ral 6'l lltrm'l'llr l6lu{ llils


85

a

.q u da X2 . 19. 2 Ft6lNr{U69tn I u0 HBV

dtu v (s Yila5lNtru69r9r r d0

oZn15nqlU0 HBv

frorfro rri6nr$a

t'ltl 952 Confidence

ORa

rdrnufi

10u

rrivr:ru'irfio r f;o

r,rio'tri

49

2

22

72

1

43

t2l

3

65

1.00

0.34

1. 33

0.01 - 6.76

1.68 - 2.62

T',ul 116 73 189

a tllnnlifinulnu'ir nr:dftd#rrfudvrr.r r no6o r$o Hgv lrjfinrlrfllfiu$riun'lifielu,

rflolli-ilduo-n[ilu fi tuqnnrnrli{mlltnnn1$l$trm: fi:sfrufiuar6'rgnr.,rafifi o.os


88

f

2.19.3 n'lrandoun'lt! tn6

J a f t .t v Jr|t,|i|tl 58 lldrN?nmmTtnntia EBv lnnnrrrr.hguiafuruirn{ tn6nnrrnTUrlrl

f,$ril :

ldo,ufrta,udt,[un =7en d=41 orr

nr:rrldsudflifird

firrr$o imurf,o fiorf,o rl0finrf,oa

TFIU

ulrns

1007331024

11il 4 ,. 3 10 31

,'rno.r.rd bg rfiur#fifignn'rn:firfifiopriiuliumfin::runrr rlrof,lrfudriu

rhsmnrfur{ 4e nu ernrnnundfirnefl$ftrd rag nu (nrrrtd sOl horfiu{ouns

.r 26,9

^.-^,' -.i-c 6t, ttrt dunn1nfifrRn'unrfiil$?6t16to, uffru, urir, ttgn Ngtilua{olsu{ ? nu cnn-ti -::---ri-'- -.-- -

ato t 6 --.6 o t!l-tu?u 122 Ftu st9{noruo ItBv 4 nu $nson 3 eulstNnrt6erdo

1uiln'rum$6u:5rri 1?6 nu fiffrffnrrou,{oofi 4t nu fi{fiorf,o t0 nu unctli

. frnr:fir,$, .u.u 81 ou

odorunlnorn:ffiniirruru#r rfioternfifrrdil'olnnrrfiruflr?ouu',n 6rtriunnrtod ,v v Ct o

n'l'rNnu0{ n5tru}nr8no I nou€

!r ni,ts rri6t1rf1xoil'rruunro ro, fronr:i r n:rs furrlq{u r dur rdCopyright by Mahidol University

87

I

a.an.|lr{n 59 eprh{b r 6iw ianr:f,n r fotrfadrn-n r au fl trqnnrrl:irrs'nnn!

narm rnt: fifiarruflufirdii:cfintrfidq 0. 05

rJqftl OR (P-value)r 958 confidence OB

t. r'luldatouo:"reio r 6au

- -a d u , ia --A e . a( I utuu I ytuununnilnN:'tul9tnt0uni?a0 t 00u 10,000-15,000 u,tlt )

t< 51000 rnvl

- 5,000 - 10,000 mn

e. nr:lfrt-urf,oo

5.09 (0.0004)

3.15 (0.0045)

3.94 (0.0087)

2.63 (0.0193)

2,52 (0,0297)

1.96 - 13.46

1.39 - 7.32

1.34 - 12.39

1.15 - 6.02

1.09 - 5.90

1.39 - 4,49

1.38 - 4.03

1.19 - 3.39

1 r uiuu r fiuurTunqrufirilfiu:s r?rd:-u r f,oo I

B. o'ru (rufuurfiuun-un;irufifi0'lu zo-24 fi)

- 30-34 fl

-)40fr4. tsus t'lnTl"tt'lu1u

I:qfi?,rurn > Lo iJ 2.49 (0.0016)

(ruiuurfiuffin{liinr\t'ru ( 4 fl)

s. fi tnaflirirudrYusir.r rno 2.35 (0.0012)

( r rJiuu r fiuurTun{uiird r nrufi r nnf,lfiud 1

6. fidnrun'lsrilusdri 2.00 (0.0079)

( r Uf; uu r fi uurYuRnrumwfi Ni ltlilo )

" X2 test


88

I

5.1

a

a

a9qa11 Nn{ UFr6r'ln5 5 s OUUS u'llI

N'lu-'rurl. da , e r dA- a ^ J.

2 . 5lntullytInnfl1\r nu u0NU6hr tnonolnrulurr6tc n1uu0n1:{ trulu,lafrd,t\tu u. C unu r et?'rFht rr on0 NRtu'lufioEs f, :U'i'Ifi nxtNa#-tunf, .r rYufi srrlI--sdq.ai.e.olsou 16ru1nu [gtflnCIn5:Nt6lthtu0{unn'ln:n0'lettan9i1\tnu I duI

tilu rnctio.tlitst-o t.rruirfio-sr:rnr:fisrtactn'irufru{1udu1uIr{nu1u1nil{nrui,ln-r:

3. Uonq'lnun0nn:rN5t'luuFtFt6t I ?iu 150,.r u0{ I fiflf,umrdfrilres ftdru 1fiu?

.Dd6

fro,r uri'irqs'tiRur:nu1l'r l rfiuu r fiuutdfinrru

iaI U0it qln I UUl:\t lt{U1U16l

nrf f,-ri,ifl r f, oo luuilruan

a6

rmn 5

afuhruna a1I irr:ri uacfiolltuouw

ofuJnuna

5.1.1

q.tnnlrfrnur'tun;llgnnlnr lr'illu z9g Flu rfiurnnraflrueturu zs6 nuItt

(5ouau Bb.9) urrruluenr'ru 42 au ({auas u.1) vrurio:rnr:6or#o HBV (0verL, __ u 4. o alaarl) louns 53 ogt5ln'lttullvnus (HBsAg, HBsAg + Anti-HBc) 50uas e.z {frfran

u?nilolt Anti-HBc orirrtdur{ouns z0.e ttnsfifin:'lEmlnilulnuoit Anti-HBs otirrrgdraet

r6ru't uos Anti-HBs i?$nu Anti-HBc :1lr50unu 23.5

e1nr"lnn"lifinur0'nilnr6o r $o HBv l#runlu I nrufrn#r 6ur n'unr:frnu1u0\t

oldnr:ourn'utan tdofl n.n. zstl-zlLB dtnuo-o:rnrr6orf,aruuaaln:1r,n{?J'rura

{ouns b6 (82) uosnrrfinuruo,r rod'l oiaud fitro*-,u',ou.rulun 1{ouau s0}

(38) -rraifioirn'irdq:rnrtfio,$otutro*'lurnbruyr5usrn'lt d,rfidnna.rfi.r{ouns 76,?

(39) rfi'tesrfii6nrro51Evn{ serology i6rfiurn-ufiqru rsinmlunnoir.rfido{fier:ru:r

rfiuri

1. nroun'rodr{ fifisou I uetn{rrn'iruo{ lt{ nu'lu'lnil{l|iU5T1: I ffi,ts+... j. ^ ' ' Iiur: 3r nhr runurudolfitonril6:-uflqe'ufi r 6u{ donrrhq r uo Hsv


89

J

t

o'nr 1n1r r frunru, u a{ uail1nr 1: { fiu'lman"rn{\t r nd r fi tde'lnnr: fr nurn{r, t'

f,rriufl nfir{ E1na-n:rn'l: r fiuvnuc s 0{ urc u'rnl rtriu uddmrnlr n:lEvflr Anti-HBs ulrs

-o'tAnti-HBs fiu Enti-trsc fiugi"rn'i'l'luuisdlnrfr?1u fi{fluurc$rnrflounu 42.4 (561

5.1.2

isus t?n1n.tlyt'l{tulult\t}{u-tuta t'm'irfiorrruusrnsirtfi:so'ufiudfn'rgfu

niiufivr'r.rruuru#ruri ro fl$u'rrl riorrliuurfiuuriunrllfin*r,r'ru1ulr{xururafioun.ir a flnoondorffunr:frnm1uu'ht:ruua{au:iortinr (rgi rnenr:frnuruot rout niilud fi

uiirutlrrfurunrtfiqrfro HBv 'luuv{vrdorrm u6rcnululnoT1fl tlel d,r{dn"wrumurun.ir

firfiururd'irfitonraflruir'a Hsv rnurun'ir uruv rdurffuriofrtonrafurfrofifiranrRfl{rrnfi

#runrurfirdurdurn-u

nr:ffifiarf,an

nr:fluriar6oo u:cnoudranr:fliricrfiooqlnnt:rjfirffi,rru ndmda nr:firarirfiuttq#fi:anrofirffarfiooratoHfinfiruf rduri nr:rersrfion fioar yr'ruwa n-r:uun-

tTu-gn?qtfioo nrrr"no'o nttn.tnaan nlin.ttifu n'l:eti'lanuld nr:ntotrmroro-rfiuuus ntirfiu#r.rro4o,rfroilr6'0, nhnoo, orh:nhufio,ru0rffinr: nrrusflr.rfirr$ourfioo

a aJnr:Furirfrnuu'lilnurlnsr;iriovrr,rriuurule nr:id:"uqfifiluq1u{,luurue1 (rriu nntfiurfu#tuvt,t rfirfrtrfi,r, fiotfruuanurwn:rerf,oouir#'ro,o{r'tfio, nntufiErninurwr^iror-oy

uonernf,B''r finurfi,r nrrufitunr:il'r.Jfin r f,oo nr:rJfiuGr,tn'.,r o,ln , f,ru , f,o, nas nrrfi r f,on

, fou t $tuqrur,l€o r n4o,r ruu:lurrE ufirffi,r ru rrinuirrlqiu r r,rdrfifinrrruunndrl rTu lunr:fin, do ttru I do r u€uu r fiuu:s r,r'irr niirufi&rrin r f,ooar rTun;iufiftrr"r'a r f,oesirt r,#auirddu'notfunr:Ufirifi'rru

Ernnr:6nu-rruutif,

trulusirrffis r ytFt rasluuis rvrfldrrri

nr:finur1u1:.r nururnr.trotr,lr! ( ar )

o . d . a d,uu?'lNn'l'lN$nnnlit qtnn-l:Ff nu:tyt!.nulrluuntuttu

nrrfrnur:luara:-ga r ltnr ( 1? , 1g ,lg ,24,26 ,z?,6t

rr618 5'lu.t'lunl: I iuilluu0{ uFtfllnt1t,t t{u1u'l0t'lx.tI


90

t

a

a d i ' "rrnfirfifinrurfiutrnfiuo'nr6tu6t\r;tofioniiufin'rr,lrird,errrf,oq$arn6itlfi6uq(35)yrt'ru?'ltE"rr4ulnnmrtuulinqu oI r r

airunr:ntn6roolurl,,rungfrui rrt d,rfironrafrufiRn'urf,oourn usitrfr,.rntoon#o.rriunrfinur

ruuo{rrf (zg) 6,rfinurluunarn:fime-rnfiufifioruunuo{ HBv m Hanr:finurtdwu

omlunneir,r run{rud#ru,ia , f,rrlao mc n6irfiJufia , f,ooi.r ,f., fio'lo , fiuaurfi.irernnr:Boti , -8jia . u

t SoflvtuttwiuorulufiufififinmmnRt odrr ffis r yrrttl4u o'rqule"lnnrrBe r f otuUNdu.luun'lu

ilq{u rdunr:fi ryroa'rufiud n1iil-n,.r-f,'lnifioufirfironrn6o r #oq1nn1\ru.rouin:ourri{dr

rurnn'irnr:ffrufia rf;ao:ouit'luiltue'r *nrlnf,froorqfrfiofiowaroludrunnuE'rruuiasoa-d-^t-aou4t"r]qiufird:.u utouw tFru'rnuo'lErunrruunwiortunr:6ioor:rfmr#rfrqnnilrfrr.teludon.tnrr

nr:ltfrnr:{nurnururnudfirirun'uo"n r nu rdmrirfiomrunnEirr rYu r fiaa

ru€uu r fiuun-unrirufilrir nultfntr:-nu'lu'nnardffilruor-uo-n r curndou drrfruruanrrflnurluItl

tuoril'unc{unn (31) uns nruo-nd r-emdi u6rsa0g (er) fiyrudruanrn:fifiurur?orrafitog

ilrust'uo-ntf,u . fio-o:1n1teri'lqv{u Anri -HBe O tfofiolr,drn..n..rMnuor#ilruo-uIto

a d I o 6- , t A0n [ 6lu1u15{ lt lu-lnn.ltm$r [ ]ruxNa"urul*urnun $nc oreFtr r unElno'l'truqluou aroouF

A!.dgtlgn1 Tr,l0t16t1o0 n ilx uuu{ 6t'l u

nnfin::runrt t vmt nu:irnririifi r rof,rurtudn-usirt r no fienursrnsirr d:s o-ufiu

--a a i- 6. , i' -ct a o . j .d o u (. .n16'rg unuftnrrrutfiuttilu z.es rfir rfioruiuurfruurTundrufrtilfirnon"rufrid;i.rurun;irufifi

tt'trlil'Nfiuffiutvmt6urn-u#u rfiun;irufifirnnflirfiudn'urowi.o rr.lrtraft,rn'urnorafoidrurTu {,rfi

tnoa'ruthrdtuil-nuns oral-oral uStB oral-genital qrnnrrfrnu'luO\t,..

schreeder uflsong (47) nu'irnr:fitnof,rufiudruififirdutrionr:fir,f,o tlru fioun'irtfi

Anal-genital intercourse u50 oral-anal intercourse uasfiqhtfutfiut B Ftu

Ftlr4i'uuonrn:fifirno#rufiudn-u#{no.r rvrnriu fieh{rurfiu{ 1 au ffrrfuir rfiururdfir,ru'irrugtr..

n-r na t nairufitrifi nnilunndn.r riu r fi o r uiuu r fi uufrundrufi ril r nufi r rwrilufuflt

.a, - ,t o tnr:frnur'tudrunrl6n::Nvnit t$rrl fr.rrueir.rU:s tndrras'luU:s tylrt frirunfil

uonpirtriutu,{rooror?'rru5l*6i0uyn{ lnf, (44-5s; a-urfiufie{ui.r rnilfinvr-ruao.rnr:60,f;0d- - o oC ^ o. aq UHBv nr:6nur'lu?srild (48) nulutruinirrurvroarfrriauns 64. g tru{nRo\t lrrtstiouos 42.1

{}

?

ra^rporfnfrror{ouns g0. z ii, utun;iruuruuauufurinsir.r rnolilunnsir{ffud0{ouas ls.9Copyright by Mahidol University

91

;

unr{aunr 1g.5, tufrrur:rfinr:finuruo,r lm-u dnoiEr udEon&'(se) firsrsfinurrunfi'rat o 6 a s a .at . @ a tt A

0rdnnrqurusuurnuufluurl;tnuuru Hual']rudna1\tnuuolau (xouns 90.99 [t6lslogau

5s.g6 olrato'u) otirtt:finrrunr:frnurludrurlrofiruvtudn-un'rrfiu,fio ,ru u-{fifroulrn

t

9tu

'IurJ:s I vtrllytu nrr6nurluunnrnrlr{ flu'lulnn'lu}I,r r ndtluoi',t fi unnt run1fin:ru'irI

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fuuuilorqdotfrqrrrurrle{urudruurnfin::ru;iruuaon uone'ln'i'rcs6o.rnrfi,rfitfle{unrutu

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fioqrffofi vr"t.lfinr:finurdru r nofirfrudluuanrn:1r{ }^ru'ru-rfl 1uni.r fir*

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:ru16:'utfi0oa'ln6l1tr4ervn{o'rusnriru E rulu 24 Fru ld:-urf,oodoufisurnr:hfrouo.rT:.1

?lu'ru"r6r esfinr:o:rEriorunrfioodfi HBsAg oon 1o'unnru 2b30; i6 npne) firfiu,r 1

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6orflo eo nufio'rqtdr-urf,oofifi Hg"ae rfrrru

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l-tld6o3et@ar9,o'frorEfinrrfiorfio Hev tfi urnfir rirg'irrurfioosfrsrriufi HBsAg od unsorqfinmrurfiu,r

u o _-rto d d a tlo{uun'15'16nur noo I HU{uflstr 9tu't

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fiqft,nrtuersionr:fiorf;o HBv dru vrrr#rhuoit odds ratio fioruqrnrireir rfr,,fi,firtt6 A tt i u ' vu

tl'lE'1non6fi6l?l0it confounding variable lu'lil'llnuluoil funr:finurtunitffifloqm-o

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'tun'lri I nl'ls fi rtns ill11f power uolt nliyrorlouvrl{ ilfi fiilorioumlU

orfn tilfinmuurrnoir,rrYutudruorfnoionr:fror$o HBv tun{ruorfin s

nrirurr,rrfirfruri urintrunta'r"lil6tsoro ufin.rrufrrixurilf,onulfl nururnrnofrn v{u'ru'liliu"rfinuaitttt

r a'lurJ'lyfvfu'lu'lir nt:finurn:"u fifrimnsir,r rTun"r56nu11udra:io I Ntnl (Zg ,26 ,27 ) 1ufliaa

t eru ( 30 ) , $nr r uostiuns {unn ( s t ) finu'irfiomruunnsirr tuniixortyrfifiurirfinrl dnun::ruI

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uttonwH$I

Blunberg B.S. PolynorBhisns of the serun Brotelns and the

deveroBneut of isoprecipitins in transfused patients. Bull

NY Acad Med 1964; 40 : g77.

Krugnan S., Gocke D.J. Introduction and historical aspects. InViral hepatitis. Major Problems in Internal Medicine, Vo.

' XV. Snith LH ed.. WB Saunders Co, .19?8 p 1:.b.

g. rafiu: sf,ilsrlfiund . tnl4s00tlr{afrua-nrdufilunu. 1Til'lrnxenr:try{nd ZEZB; 10

: 1': 65-68.

4, In' r Annual Suinary of Notifiable Disgase, Division of

Epideniology, Ministry of public Health, Thailand 1gg7.

5. 5til$Ud urequoi. sr'uo'n r auernlxi-Flud{ nrrld:-u r fioo ; unurnuo{ 1'n-61 non-A,u

non-B (NANB). x'1561'lt1:o6orEo

30) 86-91.

tldsu'ld'luaniln. 4,2 ( ll:u.-fis.,

6. rngiw{ oi{mmn. lr{f,s'uo-nrflufiunsrusr{rnu. 'llr :: lr{Rffuo'ntdu"lmJ:srvr$t'lyru.

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o'nuralt'u, zEZ6 t ?o-gz.

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du, ?'l:6t'tr1:Ftilsl{,t zlzi; g : 1 : 23-30.auCAo€u8. rnnulmto lnfi{flat, t'.tf,::ri flrUrUrfrUrUe, fiernuu iuor uns fiu:'oti f,firrfimunrr.

Hepatitis B sunface Antigen In Liver Tissues of tiverDiseases in thailand. 1u : 1t5'il0'uo-nt6luluu5etnfnytu.

iuvrnrrd rufr, ururntg flo,rraiq, u:rfxxBn15. flr\rfnn1 : r:gfiufi

o'nurnfiu 2526 :1b9-16s.


L02

?

9.

10.

11.

Alward l{., Mcmaho[ B.1 HaIl B. t et al. The long-tern serological

course of asymptonatic hepatitis B virus carriers and the

developnent of prinary hepatocellular carcinona. J Infect

Dis 1985;151: 4 :604-608.

Beasley R.P.1 Lin C., Kwang L., Ghien C. Hepatocellular carcinona and

hepatitis B virus a prospective study of 22r7O7 nen in

Taiwan, Lancet 1981; 2 : 1129-1133.

In : Handout. International Conference on Prospects for

Eradication of Hepatitis B virus Geneva, 23-24 Februarya

1989.

12. SarnBliner 8.E., Hanilton

and frequency of

antigen (Hgseg)in

?, L7-22,

13. ehnn.rf tsfi. ltr'da'uo-nldu. 'llt :

AUl5fnEn15. fll\t lYlt{"| :t

F.A.1 Isert 0.A.1 et aI. The liver histology

clearance of the hepatitis B surface

chronic carriers.Am J Med Sci L979', 217

1r:-dirturnrruv{flf zsgo. iunntd rufl ,

1:rfirufo-nu:f,liu, z53o : to?-116.

L4. Emnet B.K. Clinical approach to viral hepatitis in honosexual

nen. Medical Clinics of North Anerica 1986; 70 : 3 : 56?-

586.

15, Weller I. Viral Hepatitis. British Medical Journal 1984; 288 :

47-49.

16. Franklyn N.J. Sexually Transnitted Viral Hepatitis and Enteric

Pathogens. Urologic Clinics of North Anerica 1984; 11 :

1 : 177-185.

17, Pattison P.C., Maynard 8.J., Berquist 8.K., Webster M.H. Epi,denio-

logy of hepatitis B in hospital personnel. An J Epidenol

1975;101:1:59'64.Copyright by Mahidol University

103

O

18. Levy S.B., Hamis C.J., Smith L.J.1 et aI. Hepatitis B in ward and

clinical laboratory enployees of a general hospital. An J

EpidenolL9T?;106.: 4 z 330-335.

19. Dienstag L.J.1 Ryan M.D. Occupational exposure to hepatitis

virus in hospital personnel : Infection or innunization

. An J Epidenol 1982; 115 ! 1 : 26-39.

20. Harris B.J., Finger F.R., Kohayashi M.J., et al. The low risk

hepatitis B in rural hosptial. JAIIA 1984; 252 | 2g

3270-3271,

21, Laureen M.K.1 Donald E.C., Barbara G.W., Lenworth M.J. An J Med

1983; 75 z 269-272,

22. lierry J.A., fsaacson J.I.1 Kane A.M.1 et al. Multicenter study of

the epideniology of hepatitis B in anesthesia residents.

Anesth Analy 1985; 64 : 672-676,

23, Denes 8.A., Snith L.J.1 Maynard 8.J.1 Doto L.I., Berguist R.K.,

Finkel J.A. llepatitis B infection in physicians. JAIT|A

L978;23923:2lO-2L2,

24. Willians V.S.1 Feinglasa J.E., Gregg 8.M., I{atsen M.J.

Epidenic Viral hepatitisrType B, in Hospital personnel.

An J Med t974; 57 :904-911,

25, tewis L..T., Alter J.H., Chalmers C.T.l et al. Conparison of the

frequency _of hepatitis B antigen and antibody in hospital

and Nonhospital personnel. New Eng J Med 1973;28g : 18 :

647-651.

26, Snith L.J, r Maynard Webster M.H. I

anong

133 16 :705-706.

targeted for

Sheller J.M.

B

,

of

t

a

8.J., Berquist R.K,1 Doto L.I.,Conparative risk of hepatitis B

physicians and dentists. J Infect Dis 1976;

27. Grady t'.G. Hepatitis B lmmunity in hospital staffvaccination. JAMA 1982; 248: l8 : 2266-2269,


t104

28. Callender 8.M., White S.Y. r Willians R. Hepatitis B virus infection' in nedical and health care perconnel. British Med J 1982;

284 z 324-326. .

Hovig 8., Rollag H., Dahl o. Antibody to hepatitis B surface anti.gen

anong enployees in the national hospital, OsIo, Norway: a

prevalence study. An J Epidenol 1988; IZZ : 1 : tZ7-L94.

Christenson B. Acute infections with hepatitis B virus in

nedical personnel during a lS-year follow-up. AE J

. Epidenot 1985; L22z 3 : 411-41?.

Janzen J'., Tripatzis I., wagner u., schlieter IrI., niirler-Dethard

E., lfolters E' Epideuiology of Hepatitis B surface Antigen

(HBsAg) and Antibody to HBsAg in HosBital personnel.

J Infect Dis1978; L37 :261-5.

gz. e-uvtfl{d ruf,, u:utnig vra{leiru, r6t-rxi6t duiyrur $nson&. nr:fior#01.r:-drTu

o-n tdufilunuJytg, 'lu : lt:-da-uo-n lilu'luuis lyt$nt4u. iunmf rufl,

U:utn:^g ytoinst$ru, urrnnBntt. flytrJ. : 1:lfitfio-nuiil$Tu , zEZ6 :

166-1?1.

gg. {uvrur niltoun. nr:finurfianrfiuie1,tr:-iluoufirquJriaffuo-nrtuufinfi lufirhuung0

{firfrunrHr. 'lu : 1'lt-;lsr-ua-nrilu.luuTs IyrFt'lyru. {r*rn,rf ruf,, u:y rai5a A _- _ o (s oyloit tg5ru, ultfu'l5n'l:. nl,t 1flH"| : 1:,mtuudnu:5tilt-u, 2526 : 179_194.I

1

29,

30.

31.

I

34' ifin r'trqr'nfi nns tfiruf,u luuu{h. n'l:AnulrSo,rtrfaduo-nraufl1u1r{}ru"'rnnAi

i'rd : nr:iinurr{o,r virar Hepatitis luRlniuroruroran{, 1u :

1'l:'ilel-u0-nrfluluulu llrrnnu. e-unn{d ru.ii, utr rair vro,r teirg,

u:tnn8ntr. nnN. :1:.rfilrfnhuriltTu , zsz6: 181-tS?., oa t -,C v 6 v q e u 3 t35. nurlnet liidtnur.'rntufa.rn'ut:nduonrfluilnrfralr:.d. nlrBufirr6d11 z1zr;

7 .: 147-161.- C -C o36. 6{lttrud unelnua. ilEutut,tu:sn'ri1u1:nfruo-ntilue'ln'l?t'5t, atniu?trfl1t zbzg;

i ,

"ro-rrr.

cA


105

37,t

38.

40.

41.

Chainuvati T. L Viranuvatti V., Luengrojanakul p., Kachintorn U.,

Plengvanit U., Ponzetto A. The prevalence of delta

infection anong Thai hepatitis B carrier. Intern Med 1997;

3:47-48.' o a -d - - i

lFrd'l Fliilu6. lt:"dEr"ua'nrilufi luunornrl{}ru'ru1ilun:utun. ?1tfl1tn:un'lilt}ryru

25ZBtt0:9:643-650.

39. Techapaitoon S., Duanglov S. r Powtongsook Hepatitis B virus

An Epideniologicalinfection in hospital personnel

study. J Dted Ass Thailand 1987; 70 : I : 4bb-4b8.

Pronqiunyakul K., and Limsuwan A. Hepatitis B vaccination in

Ranathibodi health 'personnel. Presented at the ?nd

Workshop on Nosoconial infection control 13-15 July 1988.(-.'alfinh r-nnrrti, !ru:-nri ?r1?n, {lrfi !rpl, oc tHo o$urnilns, {wr fi:nfi,

n"uo{ Hrgihri. nr:finurrJee-u r f,u{ eiol:orr{aoTudn r lufiluqnnln:80{

1:rwururnulolut!. 1u : Abstracts n.tifNtu'l:su'loinulrnilur6n{,rd

5 August 17-19 1987; Bangkok, Thailand : 8?-BB.

42. Vahrnan J. Transnission of hepatitis. Lancet 19?0; Z : 774.

43. Hersh T, Melnick L.J., Goyal K.R., Blaine-Hollinger F. Nonparenteral

transnission of viral hepatitis type B (Australia

antigen-essociited serun hepatitis). New Eng J Med l9Z1;2BE:

24 : 1363-1364. -

44. Jeffries J.D., Janes H.W., G. Jefferiss .J.F., MacLEOD G.K.,

Antigen in Patients

British Med J 1973;

455-456.

45. Fulford K., Dane D.S.; Catterall D.R.1 t{oof, R., Denning V.J.

Australia antlgen and antibody anong patients attending a

clinic for Sexually transuitted diseases.Lancet 19?3;June

. 30 : 1470-t473.

v.

l

lfillcox R.R. (Hepatitis-Ass.ociated)

Attending a Veneral Dlsease Clinical.


?

106

Sznuness W., Much I., Prince M.A., et aI. 0n the role of sexual

behavior in the spread of hepatitis B infection. Ann Intern

.Med 1975; 83 : 4 : 489-495.

Schreeder T.M. r Thonpson E.S., Hadler C.S.1 et al. Hepatitis B in

homosexual Men : Prevlaence of infection and factors

related to transmission. J Infect Dis 1982; 146 : 1 :

7-15.

48. Christopher J.P., Mailer T.P., Crewe B.E., Murphy M.A. Infection

anonEl STD clinic patients in Sydney. Aust NZ J Med 1984;

L4 z 491-494.

Alter J.M., Ahtone J., Weisfuse I., Starko K., Denetri-Vacalis T.,

Maynard E.J. Hepatitis B virus transnission between

heterosexuals. JAMA 1986i 256 : 10 : 1307-1310.

Baddour M.L., Bucak A.V., Sones G., Hudson R. Bisk factora for

hepatitis B virus infeetion in black fenale attendees of

a sexually transnitted disease clinic. Sex Tran Dis

1988; 15 : 3 :17 4-176.

Goh L.G., Rajan S.V., Chan H.S., Kamarudin A. Hepatitis B infection

in prostitutes. Intern J Epidemof 1986; 15 : I : 112-115.-,udAttl?l|:d o{oqa, il'tFlNFtso\t luuusauol, }r'lit}tuOlr uiurnrg, frQonr n15{nd,

ltnsnn&. o1']udn80{ HBsAg rlils Anti-Hfs 1uuft.rff[nfilnundur.rfr,r.

'ltl : Abstracts nl5#Nilu'lrsu'loiytulurir urfi nr\ii s August 198s;

Bangkok, Thailand : 18-19.

53. Tantivinich S., Udonratana B, Prevalence of hepatitis B virus

anong hospitality girls in Bangkok. Southeast Asian J Trop

I

46.

47,

49.

50.

51.

52,

1

:

Med Pub Hlth; 1985 : 16 : I : L27-128.

84, lw:-r 6aoio. 5uu'toiyrul?Jo{ntr6orfiorr{ao'uo'nrf,u

1u : nr:uisdrur8{ufiu6nr:. triasr'ud'nldu fi

advU : Ulu6lUnllnn'lnnlliln.

AU Aduu'lyt'l{ n15'lqu rrnv nR1 g

un'n 1un t: n'l ugln . Fuw u nyt u st't a sl{qm n { n : ntn,tr i ng r #u i r t n'un : Not uoruIt

1:prfiorion:syti'l\t;t-lo'lrr6?t ni{ rvtn't : zSzg z 11-1g.li


f107

55. Sobeslavsky O. Prevalence of narkers of hepatitis B virus

infection in various countries : a I{HO collaborative

study. BulI WHO 1980; 58 : 621-8.dA o -t i e )t

56. ifie inu{ofi. tSot:rrfrr "l lutfo\tl:nn'uo"ntdtuluutcrilflnud.lusiodnqufi.r

r1aliu; Prospects of hepatitis B control in Thailand 'ltl

Proceeding 3ra Seninar Epideniology; 1985.

57 Grady G.F., Chalners T.C. Risk of post ransfusion viral hepatitis.

N Engl J Med 1964; 271 t 337-42.

58. Allen J.G. r Saynan W.A. Serun hepatitis fron transfusion of blood.

JAMA 1962; 180 : 1079-85.

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nlrn{{ lnd:


LLz

t

ttttt 6faur|-ral

A,llHUn/0n/ilUXU.l1U .....................o.......... l4N.lUlnU

noufi 1 frolafirrut

Allq!

n!

a

lru'la

1. lslFl

2, Sln',luR'll{5lN56l

[ ]u'ru t I

[ ]lf,o t ltlHffru tI

j

O'lU ......... fiI

t I nfinrrufidru rrlf,ooulfls

a u d. a €'t 1 reluu'lyrl{6lrryn1uo vAt I reluu-rvrfiu'1u"r6l

t I nu'lu.lnidlflnu€t 1 yrug|l]rIyru

t I ffdrun-uouvrvrti

d........ ln0il

t 12,500-5,000u'l?lt I 7,500 - 10,000 ulvl

5,000 - 10,000 ulvl

15,000 - 20,000 ulvl

3. orfin t I nfinrrunlo'l'lru6lso'tou ui o dt I reluulvrlvrFrunnlst]Hvru

[[HUn ..............t I ?r?J-lu-l;l[flnfin

6t I rr{vtu

t I n-uotutffu

n'1'l'lu1u1r{nu1u']nfiN'lu'lu . . . .. . . fl:rslfrdo r6ou

t I drrn'ir 2, goo u'lYl

t I 5,000 - 7,500 u'lvl

t I Nlnn'i.l 10,000 u-rvl

qanudu8nlugrrougt{r .. .. ...,. .. r

fifrfi:rurfr .......... ou

:rulduo{ a:ourr5'1e10 r 60u

A.t I uoun'l'l 5,000 u']yl

I 10,000 - 15,000 ulY|

t 1 il'tnn'i'l 20,000 u'lvl

6.

ttt1

7.


113

?

tloIalfltnEI

1. urir u.r rufi riruufififu ruodget.t I llr{un3^tu?uu0nr

tt. df I uol"ltl'lutlu ofl ...........0

2t.ot I l,to,itH'rgto

Ut I ttNunvruanrs$

t I l:rf,nron

t I [],{unflrf

t I rrHunenuI

t 1 rfloru5unuru'larilsan rAu

t I rio,,rd-udo:1ioufls6u'lnrrrfloel€t

t I fluUelUnnl\t

t I 1:.10'll,l'll

t I ahu rrdnr:rflrnn..

riruuiri6.rril'lur4lixu\t'lufrrrdumululyr'llo . . . .. fi .... . tosu

I

t I rqrsrf,oofrdru t 1 floar t I vt*uu.tn

t I uun,duiiorr.r,f,o, t I &hn-sr t I yr10n0o

t l vrrfiu tlnyranulfl []vr"ro?'rlslg0"lo,rfiutuu

t I rfiudr'rro{orflor^irdo, ro4arfiovrrnnoo uioounrrfirufrorf,udsrr

ilr'rfir,firu,f,r, t I o&ru'r6r.ru-ririovrr,r,Aur'roi,;t 1 0U 15Uq .o..................

3. drunltrulurarirfifilru'lu ........... fl .......r. r6ouIt

4 . riourafirfiriru r nruuhrifi'nuluufirur ru'lolrdou

t I trirou otififiursqr

z, rafirfiu:uet (oouldrulnn'ir r nlnou)

,.a

lN0IIt

tN0

ttriO

dtN0

aatN0

aa1N0

Id

tNo

aaaaaaaaaaaa

aaaaaaaaaaaa

aaaa.taaaaaa

aaaaataaaaaa

aaaaaaaaaaa

....q4...44

aaaaa.a.aaa

aaaaaaaaaaa

aaaaaaaaaaa

aaaataaaaaa

ttaaaaaaaaa

an{An{dn{dnil

anil

an\l

a0ilanil

alll0 . . . . r .. . . ..


114

t ia4rg .......r........... llJ0 ........... 0t[

Aa4.10 ................... tNO ........... n{

b. ffdll,rrufrurirufitnrrnu6or#o uioriru drut:nlrr-nfiuflnrdu fi firruiorri

t I fi e*u'Iu..... au 1fi0r60u......or.......... l4.flr d )u, ol r d

l4u?u\!"lul4:0[1]^tun flH:2N{1uhtul,l0u Fto . r............ r.........totl

t lllifit I lrin:ru .

6. drurnrufiornrrdotufl raiorri

t I et-l1ufio\rd?rufiot t I rJanrrcfrrflN t 1 oeqr:sfrur1fio

nf,ur# t I olriuuit 1 ruoat'll4'ni a i .i dll$N0'ln'lltlJ0'luyl ..... l9l0u ................. sl.Ft . ......

; -; al,l'lulN0'lUyl ..r........ lgAU ......r.......... yl.gl. ....r.

t I trir nufiornr: r ra;irfl r au

7 . drur nst6:-unrren?e rf,oournr:fin r #atr:-a6'udn rau fi rliord

t t lou riorn ............frr tnu rlnnrrar?e

1t,I I ni?rrurfio (rfiufrsrraiorfiunrue) (HBsAg)

{ [ ] n:?enugfi{ln-uuo{ t$onrilor:ud-}A (Anri-HBc)

t I enlqr.ru.i'lfinfrfuriuoio::a (Anti-HBs)

t I ntleily{u.irfinfi{ruf,u:io (Negative)

t I trirnu 1flrruruu'o e1

g. q'ln#o z rioyr:rurunn.lrarte riruionr:rTust'rliruodr{1:

o{ rau t lrinloctr t t r,tl,tri,rfro rfiu?n-uo-uo'n rduqrnlrr-ddru

Jrfuo:"unr:fiq{ofiu t I r{nr^iourflru,rntaaud

rflnoNonn0d0n t I :-Wrsnruo"nnrfifi1ffifiuIa0U 1 ISU .. . . . . . . . .. . . . . . . . . . .. .I


115

I

e. 1u{ruurcEt{uuardru frnesda{JNfiarf,oafrrhu

t I rd - rfioorine, rf,oufirufiiroliru

I I Tn{uaZZai- t 6t00 I uouuu l 5t0n6tulr50 I nta,t []uu

I

t I nntuorri fluorrins .... nt\

t ] nna'uorrf n'unrrfn, .... n5g'lt I t?nf,

a

- udrqrn rfiourf;ooyiru

ttdr,roanfiufi tlyr"nrusioqurn{qudrt,rfrr.r

t 1 udruti runnr:riI

t I rrirri uoiriour,r#rfirnu#lrinrf,aeriuru,TasZ6e- tnooNnas tuouuuH'tltu\r[0{n1u

t I r1n{u t I r,rnfluorrf #uorrfn, ..,, ,frua-',t qln I f,ou r f,ooriru

ttflr-raann'ufi tlvrl{rueiaquro{er#'t6.r#r,l

t I n#rueirrannr:ni.tt13gtai

- tno tuouuut6l00nNu50 I a:a){fiuu

t I flnuuu t 1 vrn#uorrf flrlorrin, .... rtr\

t I tilrdrnu rulfr#rfiarfiao{


116

t

10. firu r nutd:-ut.r dorufi raiorri lnrrur:u uiudrdriu II- nrrlu lnu rfio

-ttu . i- tetulnoo lnu lNoao

- H10tl

- uoNonn!!

- aa0ou9r5

- flnfr'rr,tri,r

et- ll.lllYl,t

- l?-lsl4!

6--iruun'r$l:n rou rrjO

ld{uar:fiorfrrnrrunoorfioo rnu rfio .......Ia

5l'lluuao . ... ....- riirioyrr{ r6uilru1e rau rfio ....,..... t I trirou

t 1 . riru r nuld:'uofifi r usrufio r fioooonune uAfiAr rur,riotri

t I rnu t 1 gnrfrr,drdu#rrnrilcnfirufi,r66.ddnridt I N0rUuttilnua]Esn'lqrioe uiourwnr{ rnio,rlo

t 1 ofifirr,rquner.irrr'o rriu gn.lufionio,3

t 1 du 1 :gu o . . . . ... . . . ... .. . . . .. . . . . ..t I tilrnu

1 z . ilru r nulfrnrrr-nur uionr:nututn rrdfidrun"uo'n r ou r,t{otri

t I lri rnu

tlrou dt I nnroou t I flas 1-2 n:\I-9 1,t I f,nu 3-E n:".t t I flns 6 n:".r

:t I 0Unl:CU .......r......o.......r....

at9ru m0tlnU JNO ....................,

EIAU tNO ................!...aIOU tl*10 .i...'.r'r..........

a6lnu 1N0Ialou 1ilo

t I 'ttrnu

t I ldrnu

t I lrirnu

t I trirnu

t I trirsru

t 1 lrirnu

t I trirna

t t trirnu

t 1 lrirnu

t I trir nu

rl


LL7

f

I g . 6tru18n1un:oun:-rriru fi rn: r nuilru r fiusr'uo"n r au r,ri orri

unntlrfiffifrefiu t I.ldifiedu'irrfiudfiot Iro t lfit 1lri'ld rounsfi

t I lil'ltit I triffi'lu

t4.\virufio'ir rirufironrilfior#o rr:'asr'tiohrau fi qrnrlirl{ruuionminlun:ouer-r

ra€oril

t I trtfr ryr:rg ... o........ o............,t I fiern t I nr:{uursnruorur:{ufiu

t I losnr:td:-unr: rf;oqern r ur

t I tounr:#rua.r'arn#Eo

t 1 rou rnrt#ur1ud

t I 6u1:rut I llin:ru

rs. unhdrufi r yrrr#r.rfiudfiu

t I rn6r6urn-u9,

t I il-.tilo.t ttt6

t 1 rrifi

rtfi

l

{ t I e,irr rxrt

t 1 rrirnuft 1u'uturrouflo rg)

t o. riru r nufi r noflirfiudfi'ufifi r fiur:o1r:-ilduo'n r nu fi r,riorri

I FIU

lrir ou

t rivr: ru'i r riflirtudfi nr : fi o r to euio'tri

t1t1t1tl trisrou


f

1 ? . nififi rirufi r fiurno lrior,rfrra rirufinr: r ufi uuri r nrtn-rurfudlriorri

I

I

I

^iu(ilnnno{CI'1iln0}ru'lu ) ndT rirurnufi rnofi,nu$rfurf,du raiofri' t I tau e'ulu .......... nu dofl

t I ldrou

t 1 trioou

t

t

t

l'

rnu eluxu ........ olr giar6ou

tilrnafirnn#urfud

Irioouai. t u a v s (o 6 6

n: frfr vtruu Err r tuufir uo nE'rnn1 I fi r yrrtflifrrri n-unrfi r,ti o nr r u'r u 0 \r vn u

,

20,

tternfo tg

$ur,rioril

II ntlq Hnn.ltat?q

tu- ra,'rNrou (Eurrou)

ntuun-r {rnldtu'r-niun:u firu1d:-un'rien'rE r fioo r fion'irfinfr6'lrTu r fioggt

t I runfi{rriuoior:n

t t rrir,ru'irfrgfi{lfrutrn

t 1 lrinnu

t I lriomq

tB. r4rnd'ru{'ir ri#rftrd rflur:or?r-f,sr'uo-n rnu fi rirufiifirJo.rfiuodrrl:

t1tItI

t onrrfi r nrtilrufiud uns nrlu:-nurqundrqc uru

1fn{ul.loutu-u

rufiuuri#ufiud

t I druqctus|:rerfiooonfidlfiu frrrrifiesfioiofiuflorn-utr:"nEr'uf,nrnu fi

t 1 fiu r:rq ......::.:r,roi......,..t I lriyr'roclr rnu

t t trln:ru tioou

1 9 . fi r u r n s't 6{un r r fl or-o fi urlo r fiul't :"il sr'uo"n r a uu fi ofi r,t i o r ri

t ] tau q"u'lu ..., r rfiru tfiuu:n rftOaea1UN6l0{ I tlo

eiluu6l'tN lr06.ti

rulj6toynu tx0I a I la a a r a a a a a a r a a a a a a a

118


119

!mtm?!|t|1 Hepatitli B Surface Antigen (BsAg) TONOCIONAL

.

Beversed Passive Henagglutination (RPHA) test for detection of HBsAg

aal'16 BPHA

t,

{

Alfiil stabilized cellse'

u1u 1 t9t0ud

2.. Diluent til[ Phosphate

serun fiqsmnoou

Positive llBsAg

Negative HBsAg

a

nliffi?qm:r HBsAg rfiodrstunrrtfiqfir, HeBatitie B virus rTurfrrnrt

nr?qn1{fr0tu0rihnr:dqllrfiuuns rfiuiisoilr-un-ufir 1 tuuflr Bprr,a test riurfiunr:

nofl oufiyr'ild.iru' uns finrrru'lrurn

Unnnn.|t

nnTrl?

ut ilrn.l

tu.r

tfiorfiosrumunrfi rnfioudru Antibody do ngs& es,nn agglutinate

1ou IIBsArt dnogfu serun

6l'lullnat?a HBsAtS e*n{lu 10-20 u11un5-il/nu?flt. rfioo.urg

dilution uolfi{Huflr

1. Autonatic nanual pipette U$enn: 0.02b nl2. Microti.ter pl.ate Ufro u uiO v-shape

3. MicrodroBlrer Uiurffi 0.028 nl rils Microdiluter Uimn:

0.025 nl

4, Ioop Utl10 1 ul

1. Anti-HBs-sensitized cells (lyophilized) Utmnt 1, Z

uto s nt do viat rfiurfiorfronnoruns rnfioufr,lu purified

anti-HBs r fionu nrudrsfi'nfiur#rni:ns{ fu t{ori'lr fiau z f.rrusiou-tt'

rfiorfirffruf,r stabte fi z-1oo d.

buffered saline 1fl Ailute

control ser[n

control serunCopyright by Mahidol University

L20

t

*

ifintutrus:rmr flsn'lu Anti HBs-sensitized cells rou r6r.rfi'rn*'uooluotrr"ru

fi f:40 serun dilution

'ltiln'mr:noiau po"itive tt6lu N"grtit" control sera nru{lU

drurufioun-u test

1. 1fl 0.025 nl nicrodropper llBo diluent 4 llUo (0.1 mI)

n\t1ul4ilN$n? 1 u0\t microtiter plate lt6lul4uo 3 l4u9l

(0.075 d) a\tuqNltn'l 2 r4uo 1 r4u6r il{'lur4nNttnl 3

2. \il nicrodiluter iru 0.025 nl uort serun n\t1uun$t[n'l 1

v,qtnfiu dilute dolUu-tunt 2,3 dilution uort serun qstflu

1:5, L220, 1:40

3. l4UO 0.025 ml Anti-HBs-sensitized cells 6lil1ilunU[O'l 3

(dilution 1:40)i.vu'lo'lg plate tu'l "l tfioilflN serun rTu cetls sr-tfut{fiarur,tlfifol

cr;r{l4'r$5un1uu1u 2 U11N\t

l4Uo Diluent 0.025 ml t;ituunru nicrotiter 5U 'rU" raio:UtstlttVrr

E act d ad- oo i2. 1ilonlfi 2.1 9t50 2.2 ',t6'l9l',l6l4u{

2.I rfrN Serun I ul (L225\ 1f, toop ,{l Serun u'lln1d-t

luunuI

2,2 tBN Serum 2 ul (t:12.5) rfiorfiru sensitivitv #u. a i -,ulnta'l rruoldrun posITIvE yr'l controf fi f :12.8 lfio

, ax1Nfiu1E

3. llugl Anti-HBs SRBC 0.025 nl Mix, lrtdorur,rnfir?o.r L-2'to.!?t1Iil,t

4,

1.

*

ifinrurruiru

I

n150'nltsloUrtfi agglutinate frtusi 2 u?nfiulu = Positive

lilfi agelutination 6a onrfiulor,tiotfiu "doughnut" = Negative


12t

?

n'r:uu5Ha RPHA test R'nl:'un:relr1 HBsAg fiU:rfuurirfio

1. 1fid'lu'lunr:ifiefiu acute hepatitis B qunu HBsAEI talnslu

5s us ttinuo\t 1:o

a. ldrJ:snounr:frqr:rurnrrlfri'nfiu Hgv u'lnml HBsAg nr:1#.r'n6u

qstritdurctuuri

r fior# screen t f,oonnuurufi'td{unrruierolunn-{ rf,on

1fl serun ,fionr*o, rflrlrf pLAsMA

AatoiotfronoOou nr:ndlil Hypochlorite sotution 1 rioor't

.,vJ50 tyll) ou'l{uOu 1 dxlN\r

^u ct et- ) - u3.'ll4lnuu-lu"tyto6l0un 2-100 c iuurQ8'lu Ssuti.l\t?t?o, E a da a ^

' I

rifurfir^rfin:eu {urinfiafiIl1u'lnuonlrgfrn (Center for Innuno-

diagnosti" ploar"tiol, crp)

,touanl:t!'hl

3.

1.

z..t'

fi aufgffnntfauqntfznnna\illwufo\nnnwuwnuf, 'r6tn9,fi tnututanufouTfr vfi nq.ti

ursunfiuasu?ntt (unfinutfiuu^uaa) ilnr, 24642g1

a,


t22

1

nlln5'lilil'l Anti-HBsAd.16 PIIA

ouanntS

6-t.adtUilnllgll?El41 Antibody 91061'lilhllU0il hepatitis B virus $50

I.tAAeta

t

orjrr:firagfi?r

Ad?fin'l

HBsAg lN0lflOO$O{[nsillRfl0U01U HBsAg qsnn agglutinate!

10u Anti-HBs fifi'Iufi5-N

1. HBsAg sensitized cells nsn'lUd"lu Diluent 1.25 nl gria

viat rionsnrtrr#r#rfi.rr{orir.rriou e drilrriotflnonou fl'l$1inc i --rt dt

tnun 40 c 'l9ru'tu 1 lFtou

2, Control cell

. 3. Diluent rl'm:'u'lfl ditot" serun ilnsnsntud?U HBsAEI

sensitized cells

4. Positive [fle Negative control serun

5. Microtiter plate UfiO "U" shape

6. 0.025 nl nicrodropper

7. nicrodiluter UU'IO 1 ul

1. vt'l dilution u0{ serun ffrrfiu 1:ZE Uimflt 0.02b nl

n't610\tuqu

fiU9l 0.025 nl U0rt HBsAg sensitized cells n\tlUilnil

serum 116lll test l4UO 0.025 ml UOil Control cell flrtltl!l5lN control

Yl'l control positive llns negative Ftlufilud'lU

t01B plate lU'l f #,rfi,rfuuur:ru Z frfuo

rirunn Assturination fi tfiq#uo aBN henagglutination IROIU = Positive 6l'lililnI control

fio.,rrrifi Asslutination tfin#s

- nntfiueo lilfi frenagglutination = Negative

2,

3.

4.

c.

l

a

n,lta'lwtfl


t23

f

-F.

n'l:nl?qu'l Anti-HBs inhcfsUfrfu

t. lflrrttqut innunity oio Hnv

z. 1flu:s nounr:fiqrrrnnr:'lrir-nfiu Hgv unc fi onr&Hanr:fior'nflu

u'ont::c'r'r 1. serun finnaounr:nldruorruuN-o:s?'{ rfrorJo.rrYunrrfior#o

z, rn{o.rfioy,onou ndlu Hypochtorite (rioErl so rrir;ta.1

0U1\IU0U 1 U'llN\l

B. rfiuriturnonoufi z-ro" c fiturfincarurflr rfiufi e-roo c

tduru r r6ou.

wfisrlou gufirfindrllnn$anIudf,n$ cent.r for rnn'nodiagaosric

Production

fi oufgffnntr'ouala\nnntaltmutio^tnnnus$rwtuFrtan{ntw'tnattu'tiou66@A

lttnlnulauaunn

{


t24

T

ounnn15

m:n:tltil-l Anti HBc

i6 pua

rfiunr:n:rqu'l Aotibody rioununa'l{uort HB virus (core Ag)

Hia Hg" & rfietiorurounrdrof,ou#ru core Ag eunfl aggtu-tinate 1oU Anti ffgc fififu serun

1. core celt (sRBc rnf,oudru HBc Ag)

2. Diluent n'n,tiuffl dilute serum

3. Positive tlRE Negative control sera

4. Microtiter plate dfro "U" shape

5. 0.025 ml nicrodiluter

6. 0.025 ml nicrodropper

1. vrl dilution uorr serun rrilfiu r:32 utrlrnr 0.02b mt

2. uugt 0.025 nl U0{ core cell a{luunt| serun

3. yl*l control positive tt6tu nggalive OfUfilUdfU

4, t01s ptate tU'l f firfi,rfuuu1i-lu Z d.fuo

b. iitun Aggtution firfiq#u

fi agglutination rfiofiu = positive

nnrflupfilfi Agglutination = Negative

n'l:a:?eu'l Anti HBc fiu:sruUrirfio

HBv mluadel

-F

oun:rflra;fiur

Ad20n1

a

0'lltfia

NTUU:HA

rt

,1

.l

r .'lfld r u lunr:ifiqfiu.i rn.n'r r fi uraio r nuld:-u r f, o

z.'lflu:cnaunlrint:mnr:1rir-nfiu Hg


t25

{

Uouafftttc'l{ I . - serum finorounr:nrdruorrmu $'6ris,l-,t r fiofia,r rTunr:6q r #o

2. rnia,rfrofirfnnilou nr:udlu Hvpochrorite sorution

lrioer,r so rrirl arir.rriou 1 dnrlr,r

3. rfiurirurvroaord z-too c rirurfiarnru$#r rfiufi e-to" ctfruru r rfiau

riru'tfluuarrou nr*fnfiniulurnuanlrnfin (cenrer for rununo-

diagnostic Production, CIp)

fr oufaffnntt'ouatulnnntalztttgtb\nnBwrmnuFtlf, st{iz,nwrutanafoulafu fr nduiuryu,nfiuaau?ntr luwfinutfiuu-nna ) inr. z464agl

L

iL

I

II


126

tl-tftetll2tr tt -

1:.r


L27

e

t.rlnnrrrr,rrinuilurarmrua'ufr d:crirtrhc-urhnr:f, nrf arr:-f, n*ua-nrdufr

1.1 Dichotonous variables (Exposed VS Non-exposed groups)

AI)

0R=

BC

n'lou'l{ fr15'l{ Odd Batio (1.1)

5Disease

Exposure Total Odd of Disease

Yes No

Yes

No

B

D

Mr

llz

A/s

clD

Total NzNr

BMI 0dds of exposure Alc

odd Ratio (0R) = AlC - BlD


128

I

T,2 IN ordered categorial

OB=

oanro8rr m5'r{ odd Batio (1.2)

variables

arbr

arbi

tevel of risk factor Case Control\r

I

2

3

k

a1

a2

a3

AK

br

bz

be

br

n2nlTotal

t

1.3 !l'l

CI

Confidence interval

for ln (oR)

for Odd Ratio (I{oolf's Method) fd gSz

L.96

sn (on) + 1.96 ***1.dl

+

Ia

t

t

o\ ORet(P

ORexPoRu L.96Copyright by Mahidol University

t29

TF

z. iln6f0wnn'l'lrunngil{rnrafifizornmlfilfirdrrwirrrh{un-unr:finr$orrr-ilfirn-nrdu

fi lnurf chi-square test

2.1 BxC

aaIN0

rrz ..X=Xx

l=1 J=l

2X=r=c=OrJ =

Eii =

(orj - trj)ti d.f.=(x-1)(c-1)

o..1J

o..Ll

urJ

chi - square sl']fl fl'lln'll{'l tU

sl'lu'lultn'l

rlytuE.tulufloNri

or",udr'''nnr:f,'{ rnnlu[nxfi i nnlr{fi ;

f

onrufifiorour'r1uunrfi i aorur{fi ;

RrCl

loufi Eii =

2,2 i6 Yates's Correction

n

;,.15t5?iluO{unlyt i

NnslNUO\t6lOru6d ;

'uYt{n:1NU0{ u0ililn{ ?tN9l

g

n ( faa-ucl-n/ztz

cE

=!

rt=f

Br

Cl

RrRzCrCz

X2= ; d.f. = t


G

Fisherts Exact Test,

(a+b) ! (c+d) ! (a+c) ! (b+d) !

a! b! c! d!

f

=/6sr'T o ri r,r ri',r a o t n ai ru fi n r r I an u q rr Un A n n s r fi uA a r c ai o rTu

pr = {ouosuiofloriruuolnrrmlriqlunairun-rotir.r tefi t.

trufifi r fiuf,nairuuornr:fir, r $o nsv)

*i=- or

pz = {ounsuiofndruuotorruRlr{Etun;irusirorir',r uofi z.

*r. * *2

=?o2

P=

{t

nl

t2

nr*n.LL

1-peturun;iushodr,ruofi rtt

oturundrdrorir.ruofi ett

r^rnfird r fiurir z r fionrr r.r grir p-varue, fiogr.-',u*nneirr fi:s sr-uriuat6'.ufi #.,r r{oo

3. tGuutfiuumrunndrluotdndru:snitnilufrodrt e niil (test of difference

between two proportions)

lnu1f z-test

q'lndnx z

,druro :

Pt-Pz

19831


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