中国云南地区乙型肝炎病毒母婴传播阻断失败的相关危险因素。
Risk factors related to the failure of prevention of hepatitis B virus Mother-to-Child transmission in Yunnan, China.
作者信息
Kang Wenyu, Li Qiongfen, Shen Liping, Zhang Lifen, Tian Ziying, Xu Lin, Qiu Feng, Wang Feng
机构信息
Center for Disease Control and Prevention of Yunnan Province, Kunming 650022, China.
National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
出版信息
Vaccine. 2017 Jan 23;35(4):605-609. doi: 10.1016/j.vaccine.2016.12.016. Epub 2016 Dec 22.
OBJECTIVE
To investigate the relationship between the failure of prevention of hepatitis B virus Mother-to-Child transmission and HBV serological pattern, viral load as well as HBV genotypes.
METHODS
2765 pairs of mother-infant matched samples were collected. These pregnant women were HBsAg positive and delivered at hospital from January 1st, 2011 to June 30th, 2011. Of these samples, 26 pairs of sera samples were randomly selected from 114 pairs of samples which failed in the prevention of hepatitis B virus Mother-to-Child transmission. Serological tests, viral load and genotype detection were performed for further analysis. Additionally, the selected subjects were followed and tested again in 2014.
RESULTS
HBeAg positive rates were 76.92% and 69.23% in mother group and infant group respectively, showed no statistical difference. The average HBV DNA levels were >2×10IU/ml in both mother group and infant group. Genotype analysis revealed that 11 pairs of mother-infant matched samples belonged to C gene type and another 11 pairs were B gene type. Different genotypes were observed in 4 pairs of mother-infant matched samples.
CONCLUSION
HbeAg positive and high HBV DNA level were two major risk factors of HBV mother to child transmission. Additionally, nosocomial infection was another potential way of HBV vertical transmission, especially in remote area of Yunnan province.
目的
探讨乙型肝炎病毒母婴传播阻断失败与乙肝血清学模式、病毒载量以及乙肝病毒基因型之间的关系。
方法
收集2765对母婴配对样本。这些孕妇为HBsAg阳性，于2011年1月1日至2011年6月30日在医院分娩。在这些样本中，从114对乙肝病毒母婴传播阻断失败的样本中随机选取26对血清样本。进行血清学检测、病毒载量及基因型检测以作进一步分析。此外，对选定的研究对象在2014年进行随访并再次检测。
结果
母亲组和婴儿组的HBeAg阳性率分别为76.92%和69.23%，无统计学差异。母亲组和婴儿组的平均HBV DNA水平均>2×10IU/ml。基因型分析显示，11对母婴配对样本属于C基因型，另外11对为B基因型。在4对母婴配对样本中观察到不同的基因型。
结论
HbeAg阳性和高HBV DNA水平是乙肝母婴传播的两个主要危险因素。此外，医院感染是乙肝垂直传播的另一种潜在途径，尤其是在云南省偏远地区。
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