Hu Xiaoling, Wan Shan, Yan Huanmiao, Tang Minyue, Feng Guofang, Liu Aixia, Zhu Yimin
Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China.
J Viral Hepat. 2025 Jul;32(7):e70047. doi: 10.1111/jvh.70047.
Hepatitis B virus (HBV) infection remains a global public health problem. To investigate whether HBV infection in women with different serostatus affects the outcomes of assisted reproductive technology (ART). This study included a total of 9891 infertile couples, comprising 1670 couples with HBV-infected women and 8221 couples without HBV infection, all undergoing ART treatments during the same period. None of the male partners had chronic HBV infection. Three groups were defined: HBV-positive, HBeAg/preS1-positive and HBV-negative groups. Pregnancy outcomes were evaluated and compared using multivariate logistic regression analysis to control for confounding factors. Decreased rates of implantation, clinical pregnancy and live birth were observed in women with HBeAg/preS1-seropositive status. Following multivariate adjustment for potential confounders, the live birth and clinical pregnancy rates in the HBeAg/preS1-positive group were still significantly lower than those in the HBV-negative group, with adjusted odds ratios of 0.86 (95% CI, 0.75-0.99) and 0.84 (95% CI, 0.73-0.96), respectively. No significant difference was observed between the HBV-positive and HBV-negative groups. Additionally, no differences were found in the miscarriage rate or preterm rate among the three groups. Women who were HBsAg- or HBeAg/preS1-seropositive exhibited a significantly higher incidence of secondary and tubal factor infertility compared to those without HBV infection. Overall HBV infection in women increases the risk of secondary infertility and tubal factor infertility, and female HBeAg/preS1-seropositive status adversely affects live birth and clinical pregnancy outcomes. The effect is likely attributed to the active HBV infection.
乙型肝炎病毒（HBV）感染仍然是一个全球性的公共卫生问题。为了调查不同血清学状态的女性HBV感染是否会影响辅助生殖技术（ART）的结局。本研究共纳入9891对不孕夫妇，其中1670对夫妇的女性感染HBV，8221对夫妇的女性未感染HBV，所有夫妇均在同一时期接受ART治疗。男性伴侣均无慢性HBV感染。定义了三组：HBV阳性组、HBeAg/preS1阳性组和HBV阴性组。采用多因素logistic回归分析评估和比较妊娠结局，以控制混杂因素。HBeAg/preS1血清学阳性状态的女性着床率、临床妊娠率和活产率降低。在对潜在混杂因素进行多因素调整后，HBeAg/preS1阳性组的活产率和临床妊娠率仍显著低于HBV阴性组，调整后的优势比分别为0.86（95%CI，0.75 - 0.99）和0.84（95%CI，0.73 - 0.96）。HBV阳性组和HBV阴性组之间未观察到显著差异。此外，三组之间的流产率或早产率也没有差异。与未感染HBV的女性相比，HBsAg或HBeAg/preS1血清学阳性的女性继发性不孕和输卵管因素不孕的发生率显著更高。女性总体HBV感染会增加继发性不孕和输卵管因素不孕的风险，女性HBeAg/preS1血清学阳性状态会对活产和临床妊娠结局产生不利影响。这种影响可能归因于活跃的HBV感染。
