本研究欲探討台灣整體A型肝炎流行趨勢，分析個人、家庭、地區的A型肝炎感染危險因子，並討論家戶中地區中年長成員的免疫狀況對年輕成員感染的影響，以提供我國A型肝炎流行概況及未來介入政策參考。研究中透過過去的研究文獻及衛生署疾管局傳染病通報資料(NIDSS)分析台灣近年來A型肝炎的流行趨勢，並以90年國健局的國民健康訪問調查資料的家戶調查資料與根據完訪家戶抽取的91年A型肝炎抗體的調查檢驗HAV IgG抗體進行分析。總共收集了3384個血清樣本，分別進行A型肝炎血清抗體與其個人、家戶、地區因子相關分析，使用勝算比估計各變項與A型肝炎抗體盛行的關係，並校正家庭和居住地區的隨機效果。本研究的結果發現A型肝炎的流行近年來有下降趨勢，年輕成人的A型肝炎血清抗體比例隨時間減少，而本土病例平均發生年齡有上升的趨勢。年齡、族群、家庭月收入為主要與A型肝炎抗體陽性的相關因子。而家庭內的年長成員感染較多也可能形成保護的效果。在低免疫力世代中，社會決定因子可能還是扮演重要的角色，提供政府部門相關單位做防疫之參考。

The objectives of this study were to estimate the age-specific hepatitis A seroprevalence , identify individual-, household-and area-level factors associated with the past infection and find the level of household immunity impact on the younger member’s immunity. In order to know the epidemic trend of hepatitis A in Taiwan, we pooled the results of previous seroprevalence surveys and analyze the data form Notifiable Infectious Disease Statistic System (NIDSS). In addition, total 3384 serum samples and their individual-, household-and area-level data via National-wide survey were collected. We assessed the associations between hepatitis A infection and the individual-, household- and area-level variables using odds ratio and correcting for the random effect. The results showed that the seroprevalence of HAV continued to decline between 1976-2005 and the proportion of young adult population susceptible to HAV became larger. The average age of local cases increased over time. Variables related to age, ethnicity, different level of household income and the resident area were significantly associated with past HAV infection. The immunity level of higher older members may protect younger one from infection. Although the hepatitis A seroprevalence rate was relatively low , social determinants may still play an important role on hepatitis A virus infection.

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