孕妇感染的乙型肝炎病毒表面抗原“α”抗原决定簇变异分析  

Mutation analysis of “α”antigenic determinant of Heptitis B virus infecting puerpera women

作　　者：刘凌芝[1] 郭傅佳 魏可慧 乔乔 叶舒慧 辛思明[1] 郑九生[1] 刘金辉 Liu Lingzhi;Guo Fujia;Wei Kehui(Maternal and Infantile Hospital of Jiangxi Province,Nanchang 330006;Department of Laboratory Medicine of College of Public Medcine,Medical School of Nanchang University,Nanchang 330006;Department of Medical Microbiology,Medical College of Nanchang University,Nanchang 330006)

机构地区：[1]江西省妇幼保健院,南昌330006 [2]南昌大学医学部公共卫生学院检验医学专业,南昌330006 [3]南昌大学医学部微生物学教研室,南昌330006

出　　处：《现代妇产科进展》2018年第8期580-583,共4页Progress in Obstetrics and Gynecology

基　　金：江西省科技厅科技支撑计划(No：20151BBG70101); 南昌大学大学生创新创业训练项目(2017年)

摘　　要：目的:调查江西地区待产孕妇慢性感染的HBV表面抗原"α"抗原决定簇变异特征,探讨HBV母婴传播相关的病毒因素。方法:产前24～48h,收集3948例待产孕妇血清,酶免疫法筛查HBV感染者。抽提HBV阳性血清HBV DNA,PCR扩增HBV S基因并测序。应用Clustal X和Bioedit软件将不同感染者的HBV S基因核苷酸与参考序列进行多重比对,分析"α"抗原决定簇的变异与HBV血清型。在线genotyping软件分析感染的HBV基因型。结果:3948例检测出178例HBV阳性标本,从146例血清标本中成功扩增出HBV S基因,112例感染B基因型HBV,属于adw亚型,感染率为76.71%;34例感染C基因型HBV,属于adr亚型,感染率为23.29%,B基因型和C基因型HBV的感染率存在显著差异(P<0.001)。18例S基因序列上检测到"α"抗原决定簇有突变(突变率12.33%),突变分为7种类型,5例T126A、2例P127T/S、2例Q129H/R、2例M132L、3例T140/I、1例T143M和3例G145R。B和C基因型HBV"α"抗原决定簇突变率和"α"抗原决定簇双环之间的突变率无显著差异(P>0.05)。结论:江西地区孕妇感染的B和C基因型HBV及其"α"抗原决定簇的点突变可能是致母婴传播高度相关的病毒因素。Objective： Mutation characteristics of＂α＂antigenic determinant of Heptitis B virus infecting puerpera women in Jiangxi Province was analyzed with an aim to prevent HBV maternal-infant transmission efficiently. Methods： The sera of 3948 puerpera women were collected for detection of HBV infection.HBV DNA was extracted for amplification of HBV S gene.The positive amplicons were sequenced for analysis of HBV genotypes. Clustal X and Bioedit software were used to align the sequence of S gene to analyze the mutation sites within ＂α＂antigenic determinant.Results： 178 cases of positive HBV sera were detected from 3948 sera samples.146 positive amplicons were amplified.112 cases were infected with genotype B HBV（ adw subtype） with infection rate of 76.71% and 34 cases were infected with genotype C HBV（ adw subtype） with infection rate of 23.29%.The infection rate of both genotype B and C was statistically different（ P〈0.001）.The mutation sites within ＂α＂antigenic determinant were detected in 18 cases with mutaion rate of 12. 33%. 7 types of mutation were found to be 5 cases of T126 A、2 cass of P127 T/S、2 cases of Q129 H/R、2 cass of M132 L、3 cass of T140/I、1 cases of T143 M and 3 cases of G145 R.The mutation sites within ＂α＂antigenic determinant of genotype B and C as well as on the both loops of ＂α＂antigenic determinant were found to be no statistically significant different（ P〉 0.05）. Conclusions： The mutation sites within ＂α＂antigenic determinant of HBV infecting puerpera women in Jiangxi Province occurred mainly in genotype B and C HBV.The prevance of HBV mutants with high frequency of specific mutation site within＂α＂antigenic determinant was not found.Genotype B and C and site mutations within＂α＂antigenic determinant of HBV may be the high risk factors associated with HBV maternal-infant transmission.

关 键 词：乙型肝炎病毒 “α”抗原决定簇 基因突变 基因型 

分 类 号：R714.2[医药卫生—妇产科学]