Volume 94, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



infection is among the most prevalent infections in the world and a key cause of gastric diseases; however, its route of transmission remains unclear. This study aimed to assess the potential for fecal–oral transmission of by leveraging its association with a disease with known etiology. Utilizing serology data from the National Health and Nutrition Examination Survey (NHANES 1999; = 6,347), the association between and hepatitis A virus (HAV), a sensitive indicator for fecal–oral exposure, was assessed. Survey-weighted kappa and multiple logistic regression were used to quantify the association between and HAV after controlling for age, sex, race, poverty, birthplace, crowding, smoking, and alcohol use. Concordant serological results were found among 69.8% of participants (survey-weighted κ = 0.30, 95% confidence interval [CI] = 0.26, 0.35). The adjusted odds of seropositivity were over two times higher after adjusting for confounders (odds ratio = 2.27, 95% CI = 1.79, 2.87). Results from this study suggest and HAV infections are strongly associated. Since HAV is primarily transmitted through the fecal–oral route, fecal–oral transmission may be an important pathway for spread.


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  • Received : 16 Apr 2015
  • Accepted : 19 Oct 2015

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