HBsAg阳性母亲HBV核心启动子突变与宫内传播的关系  

Relationship between mutations of HBV basal core promoter region in HBsAg-positive mothers and intrauterine transmission

作　　者：武佳欣 杨志清[1] 张睿君 李雁笛 赵甜静 扆琳珠 冯永亮[1] 丰淑英 汪波[2] 王素萍[1] Wu Jiaxin;Yang Zhiqing;Zhang Ruijun;Li Yandi;Zhao Tianjing;Yi Linzhu;Feng Yongliang;Feng Shuying;Wang Bo;Wang Suping(Department of Epidemiology,Shanxi Medical University,Taiyuan 030001,China;Department of Obstetrics and Gynaecology,the Third People Hospital of Taiyuan City,Taiyuan 030001,China)

机构地区：[1]山西医科大学流行病学教研室,太原030001 [2]山西省太原市第三人民医院妇产科,030001

出　　处：《中华流行病学杂志》2020年第6期902-907,共6页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81573212,81872677);传染病预防控制国家重点实验室自主研究课题(2017SKLID306,2018SKLID310)。

摘　　要：目的分析HBV为C基因型的HBsAg阳性母亲核心启动子(BCP)区突变与宫内传播的关系。方法2011年6月至2013年7月太原市第三人民医院妇产科HBsAg阳性母亲及新生儿399对。收集一般人口学资料,采用荧光定量PCR和电化学发光法分别检测母婴血清HBV DNA及HBV血清学标志物。选择HBV DNA载量≥106 IU/ml的113例母亲为研究对象,其新生儿发生宫内传播的22例为宫内传播组,随机选取其中22例未发生宫内传播者作为对照组,母亲HBV DNA经提取、扩增、克隆、测序和序列编辑及剪接后与从NCBI下载的标准序列比对进行基因分型,最终选择C基因型的39例母亲进行突变分析。结果HBV为C基因型(88.63%)的母亲共39例,其中宫内传播组19例,对照组20例。母亲A1762T/G1764A双突变率在两组差异显著(7.53%vs.27.72%,P<0.001)。非条件logistic回归分析显示A1762T/G1764A双突变可能是宫内传播的保护因素(aOR=0.065,95%CI:0.006~0.746,P=0.028)。母亲A1762T/G1764A双突变可能与新生儿HBeAg水平有关(P=0.050)。结论HBV C基因型的HBsAg阳性母亲HBV DNA BCP区A1762T/G1764A双突变可能降低HBV宫内传播的风险。Objective To analyze the relationship between maternal mutations in basal core promoter region of hepatitis B virus(HBV)genotype C and intrauterine transmission.Methods We collected information on general demographic characteristics and process of delivery among 399 pairs of consecutive HBsAg-positive mothers and their neonates,from the Third People's Hospital of Taiyuan in Shanxi province,China.Fluorescence quantitative polymerase chain reaction(FQ-PCR)and Electro-chemiluminescence immuno-assay(ECLIA)kits were used to detect both maternal and neonatal HBV DNA and serological markers in the peripheral blood.From 113 mothers with HBV DNA load≥106 IU/ml,we selected 22 mothers whose neonates were with intrauterine transmission and randomly selected the same number of mothers whose neonates were without intrauterine transmission,as controls.The whole-length HBV DNA were extracted,amplified,cloned,sequenced and genotyped.Finally,a total of 39 mothers with genotype C of HBV were selected for mutation analysis.Results Thirty-nine cases of genotype C(88.63%)were finally included in the study,with 19 cases in the intrauterine transmission group and 20 cases as controls.Rates of A1762T/G1764A double mutations were significantly different between the intrauterine transmission group and the control group(7.53%vs.27.72%,P<0.001).Results from the multivariate analysis showed that the A1762T/G1764A double mutations had reduced the risk of intrauterine transmission(aOR=0.065,95%CI:0.006-0.746,P=0.028).Maternal A1762T/G1764A double mutations appeared to be possibly associated with neonatal HBeAg(P=0.050).Conclusion A1762T/G1764A double mutations of HBV DNA from the genotype C of those HBsAg-positive mothers could reduced the risk of HBV intrauterine transmission during pregnancy.

关 键 词：乙型肝炎病毒宫内传播 核心启动子 HBs抗原 HBe抗原 A1762T/G1764A 

分 类 号：R714.251[医药卫生—妇产科学]