HBV感染者精液HBV-DNA载量对子代垂直传播的影响  

Study on the relationship between semen HBV-DNA load and offspring-paternal-vertical- transmission of HBV

作　　者：张荣莲[1] 王梅颖 陈起燕[1] 任坤海[1] 修晓燕[1] 邱丽茵[1] 黄艳红[1] 

机构地区：[1]福建省妇幼保健院教学医院,福州350001 [2]泉州市妇幼保健院

出　　处：《中华流行病学杂志》2014年第2期117-120,共4页Chinese Journal of Epidemiology

基　　金：福建省自然科学基金项目（2011J01124）;福建省医学创新课题（2011-CXB-17）

摘　　要：目的探讨HBV感染者精液HBV-DNA载量对子代垂直传播的影响。方法选择福建省妇幼保健院2009年8月至2011年11月初次产前检查孕妇（母）血清HBsAg阴性、丈夫（父）血清HBsAg阳性的138个家庭及其新生儿为研究对象。知情同意下收集孕妇血液、其夫血液和精液及分娩时新生儿脐带血，检测HBV血清学标志物（HBVM）、HBV-DNA。以脐带血HBV-DNA载量／〉5×10^2 copies／ml为病例组，脐带血HBV-DNA载量〈5×10^2 copies／ml为对照组。结果（1）新生儿脐带血HBV-DNA阳性率为34．8％（48／138）、HBsAg阳性率为28．3％（39／138），HBeAg阳性率为15．2％（21／138）。（2）父血清HBV-DNA阳性率为76．8％（106／138）、HBeAg阳性率为42．8％（59／138）；精液HBV-DNA阳性率为21．0％（29／138）。（3）单因素分析显示，父血清HBV-DNA阳性、父血清HBeAg阳性、精液HBV-DNA阳性、父对乙型肝炎（乙肝）传播途径及预防方法、乙肝一级家族史为HBV垂直传播的危险因素（P〈0．05）。（4）多因素分析显示，父血清HBV-DNA阳性、父HBeAg阳性、精液HBV-DNA阳性为HBV父婴垂直传播的危险因素，0R值（95％CI）分别为5．7（1．1～29．1）、4-2（1．7-10．0）、6．7（2．4，18．9）。（5）父血清HBV-DNA载量与精液HBV-DNA载量存在剂量反应关系。（6）ROC曲线分析表明，父血清HBV-DNA载量为10^5 copies／ml、精液HBV-DNA载量为10^5copies／ml其预测的敏感度和特异度较高，是预测发生HBV垂直传播的分界点。结论父血清HBV-DNA阳性、父HBeAg阳性、精液HBV-DNA阳性是HBV父婴垂直传播的危险因素；父血清HBV-DNA载量〉10^5 copies／ml、精液HBV-DNA载量〉10^5 copies／ml时，增加父婴HBV垂直传播的阳性率。Objective To explore the relationship between HBV-DNA load and the offspring vertical transmission of HBV. Methods 138 families who had taken the examination between August 2009 and November 2011 but the HBsAg of the housewife was negative, were chosen as research objects. Blood from the couples and sperms from the husbands during pregnancy were followed and collected for detection on related indicators. Cord blood was sampled after delivery for HBVM and HBV-DNA quantification. Those with HBV-DNA load 〉~5 ~ 102 copies/ml were chosen as cases while those 〈5 X 102 eopies/ml were formed as controls, respectively. Results 1 ） The positive rates of HBV-DNA was 34.8% （48/138） in the neonatal cord blood while the positive rates of cord blood HBsAg and HBeAg were 28.3% （39/138）and 15.2% （21/138）respectively. 2）The positive rate of semen HBV-DNA was 21.0% （29/138） while the positive rates of paternal serum HBV-DNA and HBeAg were 76.8% （106/138）and 42.8% （59/138）. 3）Among the positive ones on paternal serum HBV-DNA, paternal serum HBeAg, semen HBV-DNA, items as measures taken for HBV vertical transmission and prevention on the fathers and the first class family histories on HBV appeared to be the risk factors for HBV paternal transmission （P〈0.05）. 4）Data from Multivariate analysis showed that positivities on paternal serum HBV-DNA, paternal serum HBeAg and semen HBV-DNA were risk factors for HBV paternal transmission （0R=5.7,95%CI： 1.1-29.1 ; OR=4.2,95%CI： 1.7-10.0; OR= 6.7, 95% Ch 2.4-18.9）. 5）Dose-response relationships were seen between levels of paternal serum HBV-DNA load and cord blood HBV-DNA load, between levels of paternal serum HBV-DNA load and semen HBV-DNA load, between levels of semen HBV-DNA load and cord blood HBV-DNA load. 6） Results from the analysis on ROC curve showed that paternal serum HBV-DNA load level （10^5 copies/ml） and semen HBV-DNA load level （103 copies/ml）were better demarcation points to forecast the occurrence of paternal transmi

关 键 词：乙型肝炎病毒 垂直传播 病毒载量 精液 血液 

分 类 号：R512.62[医药卫生—内科学]