HBV高病毒载量孕妇抗病毒治疗对孕妇及其新生儿外周血Treg细胞的影响  

The effect of antiviral therapy during pregnancy on Treg cells in pregnant women and their neonatal peripheral blood with high HBV viral load

作　　者：郑丽琼 尹玉竹[1] ZHENG Li-qiong;YIN Yu-zhu(Department of Obstetrics,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510630,China)

机构地区：[1]中山大学附属第三医院产科,广东广州510630

出　　处：《热带医学杂志》2021年第9期1163-1166,共4页Journal of Tropical Medicine

基　　金：广东省科技计划项目(2013B021800180)。

摘　　要：目的探讨乙型肝炎病毒(HBV)高病毒载量孕妇孕期服用替诺福韦(TDF)对孕妇及其新生儿外周血调节性T细胞(Treg)的影响。方法选取2019年1-12月在中山大学附属第三医院产检并分娩的HBsAg阳性且HBVDNA>2×10^(6)IU/mL的孕妇共60例,按是否自愿服用TDF(孕24~28周开始服用,30 mg,1次/d)分为抗病毒组(30例)和对照组(30例),比较两组孕妇孕中期和分娩前,以及两组新生儿出生外周血中CD4^(+)CD25^(+)CD127^(low)Treg细胞比例的差异。结果抗病毒组孕妇经抗病毒治疗后,分娩前HBV DNA较孕中期明显下降,也较对照组明显下降,差异均有统计学意义(P<0.05);而对照组分娩前与孕中期比较,差异无统计学意义(P>0.05)。抗病毒组孕妇分娩前的CD4^(+)CD25^(+)CD127^(low)Treg细胞比例较孕中期显著下降,也较对照组显著下降,差异均有统计学意义(P<0.05);而对照组分娩前与孕中期比较,差异无统计学意义(P>0.05)。抗病毒组孕妇所分娩的新生儿外周血CD4^(+)CD25^(+)CD127^(low)Treg细胞比例较对照组明显降低,差异有统计学意义(P<0.05)。结论对HBV高病毒载量孕妇采用TDF抗病毒治疗,在降低HBV DNA的同时,可使孕妇及其新生儿外周血CD4^(+)CD25^(+)CD127^(low)Treg细胞比例下降,从而可能改善机体免疫功能,降低HBV的母婴传播率。Objective To expole the effect of antiviral therapy by oral Tenofovir(TDF)during pregnant on Treg cells in maternal and neonatal peripheral blood with high hepatitis B virus(HBV)viral load.Methods A total of 60 pregnant women with HBsAg positive and HBV DNA>2×10^(6)IU/mL who had regular prenatal visits and delivery in the Third Affiliated Hospital of Sun Yat-sen University were selected for the study from January to December 2019.According to whether using TDF during pregnancy,they were divided into antiviral groups(30 cases)and control group(30 cases).The proportion of CD4^(^(+))CD25^(^(+))CD127^(low)Treg cells in the peripheral blood of the two groups of pregnant women during the second trimester and before delivery and the two groups of neonates were compared.Results After antiviral treatment,the HBV DNA of pregnant women before delivery in the antiviral group was significantlylower than that in the second trimester,and also significantlylower than that of the control group(P<0.05),while the control group had no significant difference before delivery and the second trimester(P>0.05).The proportion of CD4^(^(+))CD25^(^(+))CD127^(low)Treg cells in the antiviral group before delivery was significantlylower than that in the second trimester,and also significantlylower than that of the control group(P<0.05),while the control group had no significant difference before delivery and the second trimester(P>0.05).The proportion of CD4^(^(+))CD25^(^(+))CD127^(low)Treg cells in the peripheral blood of neonates delivered by pregnant women in the antiviral group was significantlylower than that of the control group(P<0.05).Conclusion Antiviral therapy during pregnancy in mothers with high viral load could reduce the proportion of CD4^(^(+))CD25^(^(+))CD127^(low)Treg cells in the peripheral blood of the pregnant women and their neonates,while reducing HBV DNA,which might improve the immune function,reducing the rate of mother-to-child transmission of HBV.

关 键 词：乙型肝炎病毒 高病毒载量 抗病毒治疗 调节性T细胞 

分 类 号：R512.6[医药卫生—内科学]