乙肝母婴阻断中婴幼儿隐匿性HBV感染研究  

Study on occult infants HBV infection in HBV mother-infant block

作　　者：陈海霞[1] 王铁兵 唐曙明[1] 

机构地区：[1]广东省深圳市人民医院龙华分院检验科,518109 [2]广东省深圳市光明新区疾病预防控制中心检验科,518106

出　　处：《广东医学》2015年第11期1670-1672,共3页Guangdong Medical Journal

基　　金：广东省深圳市卫生计生系统科研项目(编号:201402019)

摘　　要：目的研究乙肝母婴阻断中婴幼儿隐匿性感染情况和影响因素。方法通过深圳市疫苗监测和接种网络,收集223对乙肝母婴阻断人群的血清样本,进行HBV血清学和分子生物学检测,分析隐匿性感染对传统HBV母婴阻断效果评价标准的影响;并分析母婴阻断中婴幼儿隐匿性感染的因素。结果血清学结果显示223例婴幼儿接受乙肝母婴阻断后,212例HBb Ag(+),传统血清学结果计算HBV母婴阻断成功率为95.1%(212/223);分子生物学筛查显示,183例HBV-DNA(-),40例HBV-DNA(+),该方法计算HBV母婴阻断成功率为82.1%(183/223),两者差异有统计学意义(P<0.05)。孕产妇血清HBV-DNA水平与所产婴幼儿隐匿性感染相关性分析显示,孕产妇血清HBV-DNA水平与婴幼儿隐匿性感染呈正相关;31例隐匿性感染的婴幼儿中有12例病毒S区"a"抗原决定簇出现点突变;而6例血清型HBs Ag(+)的病例S区"a"抗原决定簇没有发生突变,病毒突变对血清学漏检差异有统计学意义(χ2=7.025,P=0.020)。结论隐匿性感染在HBV母婴阻断婴幼儿群体中存在一定的流行趋势,并对HBV母婴阻断成功构成了威胁;病毒突变和孕产妇血清HBV-DNA水平与婴幼儿隐匿性感染呈正相关。Objective To study situation and influence factors of infant occult HBV infection in HBV mother -infant block .Methods NAT and serology were used to analyze 223 serum samples of HBV mother -infant block cases collected by network of vaccine in monitoring .The OBI influence factors of infant were analyzed at the same time .Results The serological results showed that there were 212 cases of HBbAg （＋） , the success rate of HBV mother -infant block was 95.1%（212/223） based on the serological results .According to the NAT results, there were 183 cases of HBV-DNA （-）, the success rate of HBV mother -infant block was 82.1%（183/223）.There was significant difference be-tween these two methods in assessing the success rate .There was positive correlation between maternal HBV -DNA level and occult infant infection rate .There were 12 cases with point mutation in ＂a＂antigen determinant appearing point muta-tion in 34 OBI cases;while there was no point mutation in ＂a＂antigen in 6 HBsAg （＋） cases, with significance differ-ence between the 2 groups （χ2=7.025, P=0.020）.Conclusion There are some occult infant HBV infections in cases with HBV mother-infant block .The virus mutation and maternal HBV -DNA level are positive correlated with infant oc-cult HBV infection .

关 键 词：阻断 母婴传播 乙型肝炎 隐匿性 

分 类 号：R318.14[医药卫生—生物医学工程]