[新生儿静脉血不同阶段HBsAg对乙型肝炎病毒母婴传播阻断失败的预测研究]

[Predictive study of HBsAg in different stages of neonatal venous blood on failure of blocking HBV mother to infant transmission].

作者信息

Yi Wei, Li Ming-Hui, Hu Yu-Hong, Liu Feng, Zhang Yang-Li, Liu Xue-Jing, Hao Hong-Xiao, Song Shu-Jing, Liu Ying, Li Xing-Hong, Sun Ji-Yun, Liu Min, Cheng Jun, Xie Yao

机构信息

Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2011 Oct;25(5):338-41.

PMID:22338218

Abstract

OBJECTIVE

In this study, we discuss the predictive value of different content of HBsAg in different stages of neotal venous blood on failure of blocking mother to infant transmission of HBV.

METHODS

150 infants born of chronically HBV infected mothers who were positive of both HBsAg and HBeAg and who also had a HBV DNA virus load above 10(5) copies/ml were enrolled. These infants were given hepatitis B virus immune globin (HBIG) 200 IU immediately after birth and were given hepatitis B vaccine 10 or 20 microg at brith, 1 month and 6 months after birth. HBV serological index of these infants were test at birth, 1 month and 7 months after birth respectively. Different content of HBsAg in different stages of neonatal venus blood were analyzed to predict the failure of blocking mother to infant transmission of HBV.

RESULTS

11 infants failed in blocking of HBV mother to infant transmission. The positive rate of HBsAg at birth, 1 month and 7 months after birth were 41.26%, 10.49% and 7.69% respectively, and were 97.90%, 65.73% and 13.29% of HBeAg. The positive predictive value of HBsAg > or = 0.05 and HBsAg > or = 1 IU/ml at birth were 18.64% and 70% respectively, and were 73.33% and 100% one month after birth.

CONCLUSIONS

Infants with HBsAg > or = 1 IU/ml at birth should be suspicious of failure on blocking HBV mother-to-infant transmission and it should be more credible if the infant has HBsAg > or = 1 IU/ml one month after birth. How to improve the blocking rate of neonates who were positive of HBsAg at birth and one month after birth should be the focus of our future research.

摘要

目的

本研究探讨新生儿不同阶段静脉血中不同含量的乙肝表面抗原（HBsAg）对乙型肝炎病毒（HBV）母婴传播阻断失败的预测价值。

方法

选取150例母亲为慢性HBV感染者，其HBsAg和HBeAg均阳性，且HBV DNA病毒载量高于10⁵拷贝/ml的新生儿。这些新生儿出生后立即注射200 IU乙肝免疫球蛋白（HBIG），并于出生时、出生后1个月和6个月分别接种10或20 μg乙肝疫苗。分别在出生时、出生后1个月和7个月检测这些新生儿的HBV血清学指标。分析新生儿不同阶段静脉血中不同含量的HBsAg，以预测HBV母婴传播阻断失败情况。

结果

11例新生儿HBV母婴传播阻断失败。出生时、出生后1个月和7个月的HBsAg阳性率分别为41.26%、10.49%和7.69%，分别为HBeAg阳性率的97.90%、65.73%和13.29%。出生时HBsAg≥0.05和HBsAg≥1 IU/ml的阳性预测值分别为18.64%和70%，出生后1个月分别为73.33%和100%。