HBeAg阴性的HBV感染产妇与母婴传播关系

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1、HBeAg阴性的HBV感染产妇与母婴传播关系【摘要】目的探讨HBeAg检测阴性的乙型肝炎病毒(HBV)感染产妇及其存在的前C区1896位终止变异株与母婴传播的关系。方法采用实时荧光定量PCR方法测定产妇血中HBV-DNA载量，对HBV-DNA阳性者及其感染的婴儿，利用错配PCR限制性片段长度多态性分析，测定HBV前C区1896位终止变异。结果HBeAg阴性产妇HBV的母婴传播率为5.75%，而且母婴传播概率与产妇血中HBV载量密切相关，高载量组(≥106拷贝/ml)的传播率为34.7%，明显高于低载量组(104～106拷贝/ml)的17.1%和低于检测值组的0.46%(P<0.0

2、1)，进一步对存在HBV前C区终止变异的产妇及其所感染的新生儿的HBV基因分析，发现5例野生株占优势的HBV感染产妇，所感染的婴儿均为野生株，4例变异株占优势的产妇，其感染的婴儿2例为变异株感染，2例为野生株感染。结论HBeAg阴性的HBV感染产妇存在母婴传播的危险性与其体内的HBV-DNA载量密切相关，对于存在前C区终止变异的HBV感染产妇，在母婴传播过程中，野生株比变异株更容易感染胎儿。【关键词】HBeAg阴性的HBV感染产妇母婴传播前C区1896位终止变异实时荧光定量PCRRelationshipbetweenHBeAgnegativeHBVinfectiouspregna

3、ntwomenandtheirmother-to-infantinfectionSHIWeiwu,ZHOUMeiying,GANLinghong,etal.CentralLaborataryofTaizhouHospital(Linhai317000,China)Abstract：ObjectiveToevaluateHBeAgnegativeHBVinfectiouspregnantwomenwithorwithoutpre-C1896"stop"mutationandtheirmothertoinfantinfection.MethodsHBVDNAloadinb

4、loodofpregnantwomenwasdetectedbyrealtimefluorescencequantitativePCR.HBVpreC1896"stop"mutationoftheHBVpositivemotherandtheirHBVinfectedinfantswasanalyzedbymismatchedPCRrestrictedfragmentlengthpolymorphousassay.ResultsTherateofHBVmothertoinfantinfectionwithHBeGgnegativepregnantwomenwas5.57%.

5、Thehigherinfectionratewas,thehigherHBVwasloadedinbloodofpregnantwomen.TheinfectionrateofHBVhighloadgroup(≥106copies/ml)was34.7%,whichwashigherthanthatoflowloadgroup(104～106copies/ml,17.1%)(P<0.01).HBVgeneofHBVinfectedpregnantwomenwith"stop"mutateandtheirnewlybornbabieswasanalyzed,andfound

6、thatallofthefiveHBVinfectedinfantsdeliveredbywildstrainadvantagemothersweretestedaswildstrainHBVcarriers.AmongfourmutantstrainadvantageHBVinfectedmothers,twooftheirinfantswerefoundtohavemutantstrainHBVinfection,andtheothertwoaswildstraininfection.ConclusionTheriskofmothertoinfantHBVinfectio

7、nwithHBeAgnegativemotherisrelatedtomother'sHBVloadintheblood.ForcoinfectedHBVpregnantwomenwith"stop"mutantstrainandwildstrain,mothertoinfantinfectionofwildstainHBVoccurredmoreeasilythanthatofmutantstrain.Keywords：HBeAgnegativeHBVinfectious