Ngui S L, Andrews N J, Underhill G S, Heptonstall J, Teo C G
Virus Reference Division, Central Public Health Laboratory, London, United Kingdom.
Clin Infect Dis. 1998 Jul;27(1):100-6. doi: 10.1086/514610.
A retrospective case-control study was conducted to determine why some infants born full-term without obstetric intervention to hepatitis B e antigen (HBeAg)-seropositive mothers become infected by hepatitis B virus (HBV) despite having received passive-active immunoprophylaxis. Cases and controls comprised 12 hepatitis B surface antigen (HBsAg)-seropositive infants and 22 HBsAg-seronegative infants, respectively. Infants infected by putative vaccine-escape mutants were excluded. Risk factors, after adjustment for the level of maternal viremia, were the following allelic base changes in maternal HBV:C158, A328, G365, and A479 (P = .017, .005, .003, and .005, respectively). High-level maternal viremia (i.e., > or = 10(8) genome equivalents/mL) was a significant factor only after adjustment for G365 (P = .027). HBV DNA sequences recovered from one of the cases, the case's mother, and three infected contacts all had the high-risk mutations. Specific allelic mutations in maternal HBV and level of maternal viremia are potential predictors of vertical breakthrough infection.
进行了一项回顾性病例对照研究，以确定为何一些足月出生、未接受产科干预的乙肝e抗原（HBeAg）血清阳性母亲的婴儿，尽管接受了被动-主动免疫预防，仍会感染乙肝病毒（HBV）。病例组和对照组分别包括12名乙肝表面抗原（HBsAg）血清阳性婴儿和22名HBsAg血清阴性婴儿。排除了被假定的疫苗逃逸突变体感染的婴儿。在调整母亲病毒血症水平后，危险因素为母亲HBV中的以下等位基因碱基变化：C158、A328、G365和A479（P值分别为0.017、0.005、0.003和0.005）。仅在调整G365后，母亲高病毒血症水平（即≥10⁸基因组当量/mL）才是一个显著因素（P = 0.027）。从其中一名病例、病例的母亲以及三名受感染接触者身上回收的HBV DNA序列均有高风险突变。母亲HBV中的特定等位基因突变和母亲病毒血症水平是垂直突破感染的潜在预测指标。
