Department of Laboratory Medicine, Huzhou Maternity and Child Health Care Hospital, 2 East Street, Huzhou, Zhejiang Province, China.
Department of Precision Medicine, Affiliated Central Hospital Huzhou University, Huzhou Central Hospital, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China.
Trans R Soc Trop Med Hyg. 2022 Sep 10;116(9):874-880. doi: 10.1093/trstmh/trac040.
Mother-to-child transmission (MTCT) is the main cause of hepatitis B virus (HBV) infections in China. However, there is a paucity of information on seroprevalence and mutations in HBV surface genes among pregnant women in Huzhou, China.
In this retrospective cross-sectional study, serum markers of 31 681 pregnant women were collected and analysed. The surface genes were amplified and directly sequenced. Mutations in the major hydrophilic region (MHR) were analysed in 171 randomly selected subjects.
The seroprevalence of HBV infection was 3.32% (1053/31 681). The predominant HBV genotypes were B (57.4%) and C (42.6%). Pregnant women ≥30 y of age exhibited a higher hepatitis B surface antigen-positive rate than those <30 y of age. MHR mutations were found in 42.6% (72/169) of the subjects, several of which were escape mutations. The mutational frequencies in the a-determinant and first loop (AA124-137) were higher in genotype C than genotype B. Pregnant women with MHR mutations showed increased alanine transaminase, aspartate transaminase and gamma-glutamyl transpeptidase levels and decreased HBV loads.
The HBV seroprevalence among pregnant women in Huzhou was intermediate. MHR mutations occur and the risk of MTCT still persists. Therefore, early screening, intervention and care for HBV-infected pregnant women should be strengthened to minimize or prevent MTCT of HBV.
母婴传播（MTCT）是中国乙型肝炎病毒（HBV）感染的主要原因。然而，对于中国湖州孕妇的 HBV 表面基因血清流行率和突变情况，信息却很少。
在这项回顾性的横断面研究中，收集并分析了 31681 名孕妇的血清标志物。扩增并直接测序表面基因。在 171 名随机选择的受试者中分析主要亲水区（MHR）中的突变。
HBV 感染的血清流行率为 3.32%（1053/31681）。主要的 HBV 基因型为 B（57.4%）和 C（42.6%）。≥30 岁的孕妇的乙型肝炎表面抗原阳性率高于<30 岁的孕妇。在 169 名受试者中发现 MHR 突变发生在 42.6%（72/169），其中一些是逃逸突变。C 基因型比 B 基因型的 a 决定簇和第一环（AA124-137）中的突变频率更高。MHR 突变的孕妇丙氨酸转氨酶、天冬氨酸转氨酶和γ-谷氨酰转肽酶水平升高，HBV 载量降低。
湖州孕妇的 HBV 血清流行率处于中等水平。MHR 突变发生，HBV 母婴传播的风险仍然存在。因此，应加强对 HBV 感染孕妇的早期筛查、干预和护理，以最大限度地减少或预防 HBV 的母婴传播。
