乙型肝炎表面抗原阳性母亲乙型肝炎病毒DNA载量和婴儿出生时MAVS信号通路对婴儿接种乙型肝炎疫苗无/弱应答的影响  

The effect of maternal hepatitis B virus DNA load in hepatitis B surface antigen positive mothers and infant MAVS signaling pathway at birth on infant non-/hypo-response to hepatitis B vaccine

作　　者：张颖 姚添[2,3] 李雁笛 王惠鑫 渠轶群 汪波[4] 李锐[4] 丰淑英[4] 王素萍 冯永亮 Zhang Ying;Yao Tian;Li Yandi;Wang Huixin;Qu Yiqun;Wang Bo;Li Rui;Feng Shuying;Wang Suping;Feng Yongliang(Department of Epidemiology,School of Public Health,Shanxi Medical University,Taiyuan 030001,Shanxi,China;Center of Clinical Epidemiology and Evidence Based Medicine,Shanxi Medical University,Taiyuan 030001,Shanxi,China;First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,Shanxi,China;Department of Obstetrics and Gynaecology,Third People Hospital of Taiyuan,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学公共卫生学院流行病学教研室,山西太原030001 [2]山西医科大学临床流行病学与循证医学中心,山西太原030001 [3]山西医科大学第一临床医学院,山西太原030001 [4]太原市第三人民医院妇产科,山西太原030001

出　　处：《中国疫苗和免疫》2024年第1期12-18,共7页Chinese Journal of Vaccines and Immunization

基　　金：国家自然科学基金(81872677,82073622);山西省回国留学人员科研教研资助项目(2023-096)。

摘　　要：目的探讨乙型肝炎(乙肝)表面抗原(Hepatitis B surface antigen,HBsAg)阳性母亲乙肝病毒(Hepatitis B virus,HBV)DNA载量和婴儿出生时线粒体抗病毒信号蛋白(Mitochondrial antiviral signaling protein,MAVS)信号通路对婴儿接种乙肝疫苗(Hepatitis B vaccine,HepB)无/弱应答的影响。方法选择2019年11月至2022年6月太原市某医院分娩的HBsAg阳性母亲及其婴儿,检测母亲HBV DNA载量、婴儿出生时脐血免疫细胞比例和MAVS信号通路蛋白表达百分比、婴儿乙肝免疫球蛋白和HepB全程接种后1-2月血清乙肝表面抗体(Hepatitis B surface antibody,HBsAb)。采用多因素Logistic回归模型分析HBV DNA和MAVS信号通路对婴儿接种HepB无/弱应答的影响。结果婴儿HepB全程接种后无/弱应答率为14.38%(22/153)。多因素Logistic回归分析显示,母亲HBV DNA载量高、脐血MAVS、pIRF3和pNF-κB蛋白表达百分比低、脐血浆细胞比例低的婴儿HepB无/弱应答率高[OR(95%CI):3.94(1.11-14.00)、1.44(1.15-1.73)、4.17(1.16-14.96)、1.94(1.38-2.51)、3.97(1.14-13.79)]。结论HBsAg阳性母亲HBV DNA载量和婴儿出生时MAVS信号通路显著影响婴儿接种HepB的免疫应答;相关检测有助于识别HepB无/弱应答高危人群。Objective To explore the effect of maternal hepatitis B virus(HBV)DNA load in hepatitis B surface antigen(HBsAg)positive mothers and infant mitochondrial antiviral signaling protein(MAVS)signaling pathway at birth on infant non-/hypo-response to hepatitis B vaccine(HepB).Methods We recruited HBsAg-positive mothers and their newborn infants in a hospital of Taiyuan city between November 2019 and June 2022.We measured maternal HBV DNA loads and tested umbilical cord blood for immune cells and MAVS signaling pathway protein expression.One to two months after administration of hepatitis B immunoglobulin and full-series HepB,we tested serum hepatitis B surface antibody(HBsAb)in infants.We used multivariate logistic regression to analyze the effect of HBV DNA and MAVS signaling pathway on infant non-/hypo-response to HepB.Results The non-/hypo-response rate was 14.38%(22/153)among infants after full-series HepB vaccination.Multivariate logistic regression analysis showed that non-/hypo-response rates were higher among infants whose mothers had high HBV DNA loads and who had low umbilical cord blood levels of MAVS,pIRF3,and pNF-κB proteins and plasma cells[OR(95%CI):3.94(1.11-14.00),1.44(1.15-1.73),4.17(1.16-14.96),1.94(1.38-2.51),and 3.97(1.14-13.79)].Conclusions Maternal HBV DNA load in HBsAg-positive mothers and infant MAVS signaling pathway at birth significantly influenced the immune response to infant HepB vaccination.Relevant tests may help identify populations at high-risk of non-/hypo-responsiveness to HepB.

关 键 词：乙型肝炎疫苗 免疫应答 乙型肝炎病毒DNA载量 线粒体抗病毒信号蛋白 婴儿 

分 类 号：R186.3[医药卫生—流行病学]