白介素28B基因多态性与乙型肝炎病毒母婴传播免疫阻断效果的初步研究  

Prelim inary study on IL28B polym orphism s and the effect of im m unoprophylaxis for m aternalinfant transm ission of hepatitis B virus infection

作　　者：杨天娇[1] 俞蕙[1] 钟华清[2] 缪瑾[1] 朱启镕[1] 

机构地区：[1]复旦大学附属儿科医院感染科,儿童肝病中心,上海201102 [2]复旦大学附属儿科医院儿科研究所,上海201102

出　　处：《中国循证儿科杂志》2014年第2期122-126,共5页Chinese Journal of Evidence Based Pediatrics

基　　金：211三期及上海市卫生系统重点学科建设项目基金:08GWZX0102

摘　　要：目的 探讨IL28B基因多态性与乙型肝炎病毒（HBV）母婴传播免疫阻断结局的相关性.方法 以2011年6月至2012年9月复旦大学附属儿科医院就诊的、母亲慢性HBV感染史的、出生后按计划免疫接种乙肝疫苗的患儿为病例组;根据HBV血清学检测结果,分为母婴传播免疫阻断成功亚组和免疫阻断失败亚组.以母亲无慢性HBV感染史、出生后按计划免疫接种乙肝疫苗的健康儿童作为正常对照组;分别检测病例组2个亚组和正常对照组儿童IL28B基因rs12979860、rs12980275及rs8099917位点的基因型.结果 病例组109例（免疫阻断成功亚组65例,免疫阻断失败亚组44例）,正常对照组221例.IL28B基因rs12979860位点及rs12980275位点基因型的分布频率在免疫阻断成功亚组、免疫阻断失败亚组和正常对照组间差异均无统计学意义（P分别0.266和0.051）;rs8099917位点的基因型分布频率在上述3组中均以TT基因型占优势,且差异总体上有统计学意义（P=0.009）,免疫阻断成功亚组TT基因型频率高于免疫阻断失败亚组（P =0.008）.在校正年龄、性别因素后,发现免疫阻断成功率TT基因型是非TT（TG/GG）基因型的6.48倍（OR =6.48,95％CI：1.27～32.0,P=0.025）.结论 IL28B基因rs8099917位点的Tr基因型频率HBV母婴传播免疫阻断成功患儿高于免疫阻断失败患儿.Objective To investigate whether IL28B polymorphisms are associated with the effect of immunoprophylaxis for matemal-infant transmission of hepatitis B virus infection. Methods Three groups of children were involved in this research, they were inmmnoprophylaxis success, immunoprophylaxis failure and control groups. A total of 109 children whose mothers were positive for HBsAg / HBeAg received three doses of hepatitis B vaccine （at 0, 1 and 6 months of age） alone, or combined with HBIG （within 12 hours after birth and in 2 weeks of age） ; among which, 65 cases were identified as immunoprophylaxis success for they had positive serum HBsAb after vaccination, 44 cases were immunoprophylaxis failure for they failed to develop detectable serum HBsAb and had positive HBsAg after vaccination. The control group including 221 healthy children whose mothers were negative for both serum HBsAg and HBeAg also received three doses of hepatitis B vaccine （at 0, 1 and 6 months of age） and had positive serum HBsAb after vaccination. Genotype analysis was performed among three groups for IL28B rs12979860, rs12980275 and rs8099917. Results No significant differences were observed in genotype frequency distribution among three groups at the polymorphie sites, rs12979860 （P = 0. 266） and rs12980275 （P = 0. 051 ）. However, considerable differences were observed concerning the distribution of the rs8099917 genotypes among three groups （P = 0.009） , frequencies of TT genotype were higher in immunoprophylaxis success group when compared with immunoprophylaxis failure group （P = 0. 008 ）. The odds ratio for immunoprophylaxis response was 6.48 （ OR = 6.48,95% CI ： 1.27 - 32.0, P = 0. 025 ） for TT versus TG/GG at rs8099917 after adjustment for age and gender. The frequencies of TT genotype of IL28B rs8099917 were higher in immunoprophylaxis success children compared with immunoprophylaxis failure children

关 键 词：白介素28B基因多态性 乙型肝炎病毒 母婴传播 免疫阻断 

分 类 号：R512.62[医药卫生—内科学]