乙型肝炎疫苗母婴阻断失败与乙型肝炎病毒S基因变异  

Blocking failure of HBV vaccination in mother-to-infant transmission and S gene mutation

作　　者：徐陈槐[1] 黄晓燕[2] 刘克洲[1] 陈智[1] 李筠[3] 王培鑫[3] 章明太[1] 

机构地区：[1]浙江大学医学院附属第一医院传染病研究所,杭州310003 [2]浙江大学医学院附属邵逸夫医院,杭州310003 [3]浙江大学医学院附属儿童医院,杭州310003

出　　处：《中华传染病杂志》2002年第1期33-36,共4页Chinese Journal of Infectious Diseases

摘　　要：目的　探讨母亲感染HBV基因变异在乙型肝炎 (乙肝 )疫苗母婴阻断失败过程中所起的作用。方法　PCR直接测定母婴HBVS基因序列 ,对婴儿存在HBVS基因变异而母亲未发现者 ,进一步通过克隆筛选法对母亲所感染的HBV进行S基因亚群分析。结果　 11例乙肝疫苗母婴阻断失败者中有 3例幼儿存在S基因“a”决定簇的氨基酸变异 ,其中 1例幼儿母亲也存在相同的变异。对另 2例母亲所感染的HBV进行S基因亚群分析发现 ,1例母亲 9个克隆所测序列与其原序列完全一致 ;另 1例母亲 8个克隆中 ,有 6个克隆与其原序列一致 ,另 2个克隆与其幼儿所感染的HBV序列一致。结论　乙肝疫苗母婴阻断失败者感染的HBVS基因变异株可能早已存在于母亲体内 ,通过免疫选择传染给患儿。Objective To study the relationship between HBV S gene mutation and blooking failure of HBV vaccination in mother-to-infant transmission. Methods HBV S genes derived from both mothers and infants were sequenced and HBV subtypes were further analysed by cloning selection if mothers were infected with HBV variants while their children weren't. Results Three out of 11 cases of children were found to be amino acid substitution in the “a” determination and one mother had the same mutation. The analysis of HBV subtypes from other two mothers showed that nine individual clones from one mother were identified with what had been detected in another case, six out of 8 clones were the same sequence as that of mother while the other two were the smae as that of her child.Conclusions The result indicated the variants in HBV carrier mothers may be present as minor quasispecies before transmission to their children through immune selection.

关 键 词：乙型肝炎病毒 S基因变异 乙型肝炎疫苗 

分 类 号：R186[医药卫生—流行病学]