乙型肝炎病毒前C区1896 G→A点突变对母乳喂养安全性的影响  

A study on the relationship between point mutation in pre-core region G1896A of hepatitis B virus and safety of breast feeding

作　　者：卢银平[1] 曹伟[2] 洪梅[2] 祝建芳[1] 刘朝[1] 杨东亮[3] 

机构地区：[1]华中科技大学同济医学院附属协和医院病毒研究室,武汉430022 [2]华中科技大学同济医学院附属协和医院妇产科,武汉430022 [3]华中科技大学同济医学院附属协和医院临床免疫研究室,武汉430022

出　　处：《中华预防医学杂志》2008年第10期739-741,共3页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（30271170）

摘　　要：目的探讨乙型肝炎病毒（HBV）前C区1896 G→A点突变对母乳喂养安全性的影响。方法收集62例本院妇产科HBeAg阴性的HBV感染产妇血标本，同时收集这些孕妇产后48h内初乳。应用PCR固相杂交法检测孕妇血清中HBV DNA前C区1896 G→A突变，荧光定量PCR（FQ—PCR）检测孕妇血清和初乳中HBV DNA含量。分析HBV前C区1896 G→A点突变及孕妇血清HBV DNA含量与初乳中HBV DNA含量的对应关系。结果62例孕妇血标本共检测到38例HBV前C区1896G—A点突变（61．3％）；突变组初乳HBV DNA阳性率为28．9％（11／38），未突变组初乳HBV DNA阳性率为29．2％（7／24），两组间差异无统计学意义（x^2=0．0003，P〉0．05）。孕妇血中HBV DNA高含量组（≥1×10^5拷贝／ml）初乳HBV DNA阳性率为56．0％（14／25），低含量组（〈1×10^5拷贝／ml）初乳HBV DNA阳性率为10．8％（4／37），两组间差异有统计学意义（x^2=14．79，P〈0．01）。结论HBV前C区1896G—A点突变未对初乳HBV DNA阳性率造成影响，但孕妇血清中HBV DNA含量升高增加了母乳喂养HBV母婴传播的危险性。Objective To investigate the relationship between pre-core G1896A poiont mutation of hepatitis B virus （ HBV ） and safety of breast feeding. Methods Serum and breast milk samples were collected from 62 pregnant women of HBV DNA positive/HBeAg negative. PCR-solid phase hybridization was used to detect the point mutation in pre-core region G1896A of HBV from pregnant women, and HBV DNA loads in sera and breast milk were determined by fluorescence quantitative PCR （FQ-PCR）. Results The prevalence of point mutation was 61.3% （ 38/62 ） in 62 pregnant women with HBsAg positive/HBeAg negative. The positive rate of HBV DNA in breast milk of group with point mutation （28. 9% ） was similar to that of group without mutation （29.2%,x^2 =0. 0003 ,P 〉 0. 05）. However,The positive rate of HBV DNA in breast milk of group with high HBV loads （56. 0% ） was significantly higher than that of group with low HBV loads （ 10. 8%, x^2= 14. 79 ,P 〈 0. 01 ）. Conclusion The point mutation in pre-core region G1896A of HBV dose not affect the positive rate of HBV DNA in breast milk and higher HBV DNA loads in serum of pregnant women might increase the risk of mother-infant transmission.

关 键 词：肝炎病毒 乙型 点突变 母乳喂养 疾病传播 垂直 聚合酶链反应 

分 类 号：R686[医药卫生—骨科学]