比较妊娠与未妊娠育龄期妇女乙型肝炎病毒载量和病毒抗原水平。
Comparison of hepatitis B viral loads and viral antigen levels in child-bearing age women with and without pregnancy.
机构信息
Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, 212001, Jiangsu, China.
Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
出版信息
BMC Pregnancy Childbirth. 2018 Jul 6;18(1):292. doi: 10.1186/s12884-018-1932-9.
BACKGROUND
Pregnancy is a unique physiological condition with the cellular immune functions compromised at some extents to allow the mature of growing fetus. Whether pregnancy may influence the replication of hepatitis B virus (HBV) is less studied. The present study aimed to investigate the influence of pregnancy on the replication of HBV and expression of viral antigens by comparing the levels of HBV DNA and viral antigens in pregnant and non-pregnant women.
METHODS
A total of 727 HBsAg-positive serum samples, collected from 214 pregnant women and 513 non-pregnant women of childbearing age, were included. Based on the pregnancy status, subjects were divided into four groups: nulliparous (n = 158), pregnant (n = 214), 7-12 months postpartum (n = 170), and 2-5 years postpartum (n = 185). The levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were quantitatively measured with microparticle enzyme immunoassay. HBV DNA levels were detected by fluorescent real-time PCR.
RESULTS
The median ages of four groups were 25.0, 25.3, 26.2 and 29.3 years, respectively (p < 0.01). HBeAg-positive proportions were 34.2, 33.6, 35.3 and 29.2%, respectively (p = 0.624). HBV DNA levels in HBeAg-positive women were higher than those in HBeAg-negative women (7.88 vs 2.62 log IU/ml, p < 0.001). HBV DNA levels in the four groups with positive HBeAg were 7.8, 7.7, 8.0 and 8.0 log IU/ml, respectively (p = 0.057), while HBsAg titers were 4.4, 4.5, 4.6 and 4.8 log IU/ml (p = 0.086) and HBeAg titers were 3.1, 3.0, 3.1 and 3.0 log S/CO (p = 0.198). In the four groups with negative HBeAg, HBV DNA levels were 2.3, 2.6, 2.5 and 2.8 log IU/ml, respectively (p = 0.085), while HBsAg titers were 3.1, 3.3, 3.3 and 3.0 log IU/ml (p = 0.06).
CONCLUSIONS
Serum levels of HBV DNA and viral antigens showed no significant changes in nulliparous, pregnant, and postpartum women, regardless of the HBeAg status. The results indicate that pregnancy has little influence on the replication of HBV and the expression of viral antigens.
背景
妊娠是一种独特的生理状态，其细胞免疫功能在一定程度上受到损害，以允许胎儿的成熟。妊娠是否会影响乙型肝炎病毒（HBV）的复制尚研究较少。本研究旨在通过比较妊娠和非妊娠妇女的 HBV DNA 水平和病毒抗原，来探讨妊娠对 HBV 复制和病毒抗原表达的影响。
方法
本研究共纳入了 727 例 HBsAg 阳性血清样本，其中包括 214 例孕妇和 513 例育龄非孕妇。根据妊娠状态，将受试者分为四组：初产妇（n=158）、孕妇（n=214）、产后 7-12 个月（n=170）和产后 2-5 年（n=185）。采用微粒子酶免疫分析法定量检测乙型肝炎表面抗原（HBsAg）和乙型肝炎 e 抗原（HBeAg）。采用荧光实时 PCR 检测 HBV DNA 水平。
结果
四组的中位年龄分别为 25.0、25.3、26.2 和 29.3 岁，差异有统计学意义（p<0.01）。HBeAg 阳性比例分别为 34.2%、33.6%、35.3%和 29.2%，差异无统计学意义（p=0.624）。HBeAg 阳性妇女的 HBV DNA 水平高于 HBeAg 阴性妇女（7.88 vs 2.62 log IU/ml，p<0.001）。HBeAg 阳性的四组 HBV DNA 水平分别为 7.8、7.7、8.0 和 8.0 log IU/ml，差异有统计学意义（p=0.057），而 HBsAg 滴度分别为 4.4、4.5、4.6 和 4.8 log IU/ml（p=0.086），HBeAg 滴度分别为 3.1、3.0、3.1 和 3.0 log S/CO（p=0.198）。HBeAg 阴性的四组 HBV DNA 水平分别为 2.3、2.6、2.5 和 2.8 log IU/ml，差异有统计学意义（p=0.085），而 HBsAg 滴度分别为 3.1、3.3、3.3 和 3.0 log IU/ml（p=0.06）。
结论
无论 HBeAg 状态如何，初产妇、孕妇和产后妇女的 HBV DNA 和病毒抗原血清水平均无明显变化。结果表明，妊娠对 HBV 的复制和病毒抗原的表达影响较小。
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