HBV基因型、前S/S基因突变与HBV母婴传播免疫预防失败的关系  

Relationship between HBV genotype,PreS/S gene mutation and immunoprophylaxis failure to prevent HBV mother-to-child transmission

作　　者：尹玉竹[1] 张培珍[1] 腾奔琦[1] 周瑾[1] 侯红瑛[1] 

机构地区：[1]中山大学附属第三医院妇产科,广东广州510630

出　　处：《中国病理生理杂志》2013年第9期1615-1619,共5页Chinese Journal of Pathophysiology

基　　金：广东省自然科学基金资助项目(No.05001670);广东省科技计划(No.2008B060600023)

摘　　要：目的:探讨乙型肝炎病毒(HBV)基因型、前S/S基因突变与HBV母婴传播免疫预防失败的关系。方法:选择血清HBsAg阳性且HBV DNA定量≥1×1010IU/L的孕妇及其新生儿,以新生儿是否发生免疫预防失败将孕妇分为免疫预防失败组(15例)和免疫预防成功组(45例),采用PCR扩增直接测序法对2组孕妇血中HBV进行基因分型和前S/S基因突变的检测,对比分析2组的不同。结果:(1)基因型:2组孕妇血中HBV的基因型均为B和C型,均以B型为主,2组基因型分布相比,差异无统计学意义(P>0.05)。(2)突变率:HBV前S/S基因2个片段的突变率在免疫预防失败组与免疫预防成功组间相比,差异均无统计学意义(P>0.05);而B基因型与C基因型间相比,差异均有统计学意义(P<0.05);但在同一基因型内,2个片段的突变率在免疫预防失败组与免疫预防成功组相比,差异均无统计学意义(P>0.05)。对HBV前S/S基因2个片段的遗传树分析也显示不同基因型的基因突变率不同,但同一基因型的突变率在2组间差异无统计学意义(P>0.05)。(3)突变热点:在免疫失败组的4个病例中发现4个突变热点:529G-A、530A-G、826A-G1和166het-dupC各1例;在免疫成功组的6个病例中发现3个突变热点:A530T 1例,A530G 2例,T531C 3例。结论:(1)不同HBV基因型间前S/S基因突变率不同。(2)HBV前S/S基因突变普遍存在,但并不是每个突变都与母婴传播免疫失败有关,仅分析基因突变率对研究免疫失败并无意义,寻找与免疫失败有关的特异性突变位点可能更有意义。AIM：To investigate the relationship between hepatitis B virus （HBV） genotype, PreS/S gene mutation and immunoprophylaxis failure to prevent HBV mother-to-child transmission. METHODS：Pregnant women with positive HBV surface antigen （HBsAg） and HBV DNA≥1×1010 IU/L were divided into case group （15 cases） and control group （45 cases） according to their neonates with immunoprophylaxis failure or not. The genotypes of HBV and the mutation rate and mutational hot spots in PreS/S gene were detected by PCR amplification technique in the two groups. RESULTS：（1） Genotypes B and C of HBV were detected in both case and control groups, and the majority of HBV genotype was B in the two groups. Genotype distribution difference between case and control groups was not statistically significant （P〉0.05）. （2） There was no significant difference in the mutation rate of PreS/S gene between case and control groups （P〉0.05）. The mutation rates of PreS/S gene between genotypes B and C were significantly different （P〈0.05）, but when the HBV genotype was the same, the mutation rate of PreS/S gene had no significant difference between case and control groups. Homology tree model based on PreS2/S gene formed genotype B and genotype C clusters, and in each cluster, the sequences of case and control groups did not formed smaller different clusters further. （3） 529G-A, 530A-G, 826A-G1 and 166het-dupC were hot spots of mutation in PreS2/S gene and were found in 4 cases in case group, respectively. A530T （1 case）, A530G （2 cases）, T531C （3 cases） were found in control group. CONCLUSION：（1） The mutation rates of PreS/S gene are different in various genotypes. （2） The mutation in PreS/S gene of HBV is prevalent, but not all of the mutations are related to immunoprophylaxis failure to prevent HBV mother-to-child transmission. To find mutational hot spots which are related to immunoprophylaxis failure is more important.

关 键 词：肝炎病毒 乙型 母婴传播 免疫预防失败 突变 

分 类 号：R363[医药卫生—病理学]