乙型病毒性肝炎母婴传播阻断效果观察及病毒基因序列特征分析

发布时间：2018-03-21 08:45

本文选题：乙型病毒性肝炎　切入点：母婴传播　出处：《中国疫苗和免疫》2017年02期 　论文类型：期刊论文

【摘要】：目的观察乙型病毒性肝炎(乙肝)母婴传播阻断效果;探讨母婴传播阻断失败的病毒学因素。方法在四川和甘肃省5家医院招募439名慢性乙肝病毒(Hepatitis B virus,HBV)感染孕妇及其新生儿,开展调查并采集血标本。对新生儿接种全程3剂次乙肝疫苗(Hepatitis B vaccine,HepB),检测母婴HBV血清学标志物和母亲病毒载量,扩增母亲HBV基因序列。结果研究地区乙肝母婴传播阻断成功率为93.39%,失败率为2.73%,无应答率为3.87%。母亲HBV基因型为C(43.01%)、B(37.63%)和D(19.35%);血清型为adr(37.63%)、adw(36.56%)、ayw(21.51%)、不确定型别(3.23%)和ayr(1.08%);阻断成功组和失败组的母亲a抗原决定簇突变率分别为30.59%、25.00%;阻断成功组与失败组的母亲HBV基因型构成、血清型构成以及a抗原决定簇突变率均无显著性差异(Fisher’s精确概率法,P0.05)。结论研究地区乙肝母婴传播阻断成功率较高。HBV基因型、血清型差异以及a抗原决定簇突变不是影响母婴传播阻断失败的因素。
[Abstract]:Objective to observe the blocking effect of mother-to-child transmission of hepatitis B virus (hepatitis B) and to explore the virological factors of the failure of blocking mother-to-child transmission. Methods 439 pregnant women with chronic hepatitis B virus infection and their newborns were recruited from 5 hospitals in Sichuan and Gansu provinces. To investigate and collect blood samples. To detect the serological markers of maternal and infant HBV and the viral load of mother and infant, 3 doses of Hepatitis B vaccine were inoculated to the newborn. Results in the study area, the success rate of mother to child transmission of hepatitis B was 93.399.Results the success rate of blocking mother-to-child transmission of hepatitis B was 93.399.Results the failure rate was 2.73 and the non-response rate was 3.87.The mother's HBV genotype was Cn43.01and BH37.633.63cm) and D19.35bat. the serotype was adrrrrr36.56aywywtii 21.51. there was no definite type of hepatitis B transmission, and there was no response rate of 3.870.The successful group was blocked and lost. The mutation rate of maternal a antigen determinant in the abortive group was 30.595.00, and the mother HBV genotype was blocked between the successful group and the failed group. There was no significant difference in serotype composition and mutation rate of a antigen determinant. Conclusion the success rate of blocking mother-to-child transmission of hepatitis B in the study area is higher than that of HBV genotype. Serotype differences and a-antigen determinant mutation were not the factors affecting the failure of mother-to-child transmission.
【作者单位】：中国疾病预防控制中心病毒病预防控制所国家卫生和计划生育委员会医学病毒学和病毒病重点实验室;中国疾病预防控制中心免疫规划中心;甘肃省疾病预防控制中心;四川省疾病预防控制中心;
【基金】：国家“十二五”科学技术艾滋病和病毒性肝炎等重大传染病防治重大专项乙型肝炎病毒免疫预防新策略的研究课题(编号:2012ZX10002001)
【分类号】：R186

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