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[HBsAg阳性母亲乙肝病毒核心启动子区突变与宫内传播的关系]

[Relationship between mutations of HBV basal core promoter region in HBsAg-positive mothers and intrauterine transmission].

作者信息

Wu J X, Yang Z Q, Zhang R J, Li Y D, Zhao T J, Yi L Z, Feng Y L, Feng S Y, Wang B, Wang S P

机构信息

Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China.

Department of Obstetrics and Gynaecology, the Third People Hospital of Taiyuan City, Taiyuan 030001, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Jun 10;41(6):902-907. doi: 10.3760/cma.j.cn112338-20200224-00163.

Abstract

To analyze the relationship between maternal mutations in basal core promoter region of hepatitis B virus (HBV) genotype C and intrauterine transmission. We collected information on general demographic characteristics and process of delivery among 399 pairs of consecutive HBsAg-positive mothers and their neonates, from the Third People's Hospital of Taiyuan in Shanxi province, China. Fluorescence quantitative polymerase chain reaction (FQ-PCR) and Electro-chemiluminescence immuno-assay (ECLIA) kits were used to detect both maternal and neonatal HBV DNA and serological markers in the peripheral blood. From 113 mothers with HBV DNA load ≥10(6) IU/ml, we selected 22 mothers whose neonates were with intrauterine transmission and randomly selected the same number of mothers whose neonates were without intrauterine transmission, as controls. The whole-length HBV DNA were extracted, amplified, cloned, sequenced and genotyped. Finally, a total of 39 mothers with genotype C of HBV were selected for mutation analysis. Thirty-nine cases of genotype C (88.63) were finally included in the study, with 19 cases in the intrauterine transmission group and 20 cases as controls. Rates of A1762T/G1764A double mutations were significantly different between the intrauterine transmission group and the control group (7.53 27.72, <0.001). Results from the multivariate analysis showed that the A1762T/G1764A double mutations had reduced the risk of intrauterine transmission (a=0.065, 95: 0.006-0.746, =0.028). Maternal A1762T/G1764A double mutations appeared to be possibly associated with neonatal HBeAg (=0.050). A1762T/G1764A double mutations of HBV DNA from the genotype C of those HBsAg-positive mothers could reduced the risk of HBV intrauterine transmission during pregnancy.

摘要

分析乙型肝炎病毒(HBV)C基因型基础核心启动子区域的母亲突变与宫内传播之间的关系。我们收集了来自中国山西省太原市第三人民医院的399对连续的HBsAg阳性母亲及其新生儿的一般人口统计学特征和分娩过程信息。使用荧光定量聚合酶链反应(FQ-PCR)和电化学发光免疫分析(ECLIA)试剂盒检测母亲和新生儿外周血中的HBV DNA和血清学标志物。从113例HBV DNA载量≥10(6) IU/ml的母亲中,我们选择了22例新生儿发生宫内传播的母亲,并随机选择了相同数量的新生儿未发生宫内传播的母亲作为对照。提取、扩增、克隆、测序并对全长HBV DNA进行基因分型。最后,选择了39例HBV C基因型的母亲进行突变分析。最终共有39例C基因型(88.63)纳入研究,其中宫内传播组19例,对照组20例。宫内传播组和对照组之间A1762T/G1764A双突变率有显著差异(7.53对27.72,<0.001)。多因素分析结果显示,A1762T/G1764A双突变降低了宫内传播风险(a=0.065,95%可信区间:0.006-0.746,P=0.028)。母亲A1762T/G1764A双突变似乎可能与新生儿HBeAg有关(P=0.050)。这些HBsAg阳性母亲的C基因型HBV DNA的A1762T/G1764A双突变可降低孕期HBV宫内传播风险。

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