302例HBV母婴阻断婴幼儿HBV血清标志物动态分析

王静; 朱研; 刘忠伟; 刘慧敏; 李世炼; 伍艺; 毛青

doi:10.16016/j.2097-0927.202202052

您当前的位置：

首页 >

文章列表页 >

302例HBV母婴阻断婴幼儿HBV血清标志物动态分析

临床医学 | 更新时间：2026-01-09

- 302例HBV母婴阻断婴幼儿HBV血清标志物动态分析
- Dynamic analysis of serum markers of HBV in 302 infants of pregnant women with HBV infection
- 陆军军医大学学报 2022年44卷第8期页码：797-804
- 作者机构：
  
  400038 重庆，陆军军军医大学(第三军医大学)第一附属医院全军感染病研究所，感染病研究重庆市重点实验室
- 作者简介：
  
  [毛青，E-mail:qingmao@tmmu.edu.cnMAO Qing, E-mail: qingmao@yahoo.com
- 基金信息：
  
  重庆市科卫联合医学科研项目(2018MSXM011)
- DOI：10.16016/j.2097-0927.202202052
  中图分类号： R373.21;R446.62;R725.1
- 收稿：2022-02-24，
  
  修回：2022-03-01，
  
  纸质出版：2022-04-30
- 稿件说明：
移动端阅览
王静, 朱研, 刘忠伟, 等. 302例HBV母婴阻断婴幼儿HBV血清标志物动态分析[J]. 陆军军医大学学报, 2022,44(8):797-804.

Jing WANG, Yan ZHU, Zhongwei LIU, et al. Dynamic analysis of serum markers of HBV in 302 infants of pregnant women with HBV infection[J]. Journal of Army Medical University, 2022, 44(8): 797-804.
王静, 朱研, 刘忠伟, 等. 302例HBV母婴阻断婴幼儿HBV血清标志物动态分析[J]. 陆军军医大学学报, 2022,44(8):797-804. DOI： 10.16016/j.2097-0927.202202052.

Jing WANG, Yan ZHU, Zhongwei LIU, et al. Dynamic analysis of serum markers of HBV in 302 infants of pregnant women with HBV infection[J]. Journal of Army Medical University, 2022, 44(8): 797-804. DOI： 10.16016/j.2097-0927.202202052.

摘要

目的

探讨乙型肝炎病毒(hepatitis B virus，HBV)感染孕妇分娩婴幼儿HBV血清标志物(HBV markers

HBV-M)的动态变化规律及其临床意义。

方法

纳入2016年1月至2020年4月于我院登记并孕检的HBV感染孕妇分娩的婴幼儿302例。检测HBV感染孕妇妊娠晚期HBV-M、HBV DNA及其分娩婴幼儿6~12月龄(时相点1，T1)和20~30月龄(时相点2，T2)血清HBV-M，分析其动态变化规律及影响因素。

结果

在2个时相点婴幼儿HBsAg均为阴性，T1时相点血清抗-HBs阳性301例、HBeAg阳性3例、抗-HBe阳性46例、抗-HBc阳性207例，均随婴幼儿年龄增长逐渐下降；至T2时相点有8例抗-HBs转阴，而HBeAg、抗-HBe、抗-HBc均转阴；T1时相点抗-HBs的滴度越低越容易转阴。在T2时相点幼儿抗-HBs不同滴度与喂养方式、分娩方式以及母亲HBV DNA等因素无关。

结论

经母婴阻断的婴幼儿血清HBeAg、抗-HBe及抗-HBc均来自母体，且逐步被代谢；HBV母婴阻断成功率高，初次检测抗-HBs滴度相对较低者，应缩短复查时间。

Abstract

Objective

To investigate the dynamic changes of HBV serum markers (HBV-M) in pregnant women with HBV infection and its clinical significance.

Methods

A total of 302 infants delivered by HBV infected pregnant women registered and examined in our hospital from January 2016 to April 2020 were included. Serum HBV-M and HBV-DNA were detected in the 302 pregnant women during late pregnancy and in their infants aged 6~12 months (time point 1

T1) and 20~30 months (time point 2

T2). The dynamic changes and influencing factors were analyzed.

Results

For the infants

HBsAg was negative at both time points

and there were 301 cases of anti-HBs positive

3 cases of HBeAg positive

46 cases of anti-HBe positive and 207 cases of anti-HBc positive at T1

and all these indicators were decreased gradually with the age of infants. At T2

8 cases of anti-HBs positive turned negative

while those of HBeAg

anti-HBe and anti-HBc positive turned negative. The lower the titer of T1 anti-HBs was

the more likely it was to turn negative. At T2

the titer of anti-HBs was not related to feeding mode

delivery mode and mother HBV DNA level.

Conclusion

Serum HBeAg

anti-HBe and anti-HBc are all derived from the mother and metabolized gradually. The success rate of mother-to-child prevention for HBV infected pregnant women is quite high. If the titer of the initial test is relatively low

the time of reexamination should be shortened.

关键词

Keywords

references

World Health Organization. Hepatitis B[R]. 2017-07-28.

GENTILE I, BORGIA G. Vertical transmission of hepatitis B virus: challenges and solutions[J]. Int J Womens Health, 2014, 6: 605-611. DOI: 10.2147/IJWH.S51138.

WANG T, WANG M Y, DUAN G H, et al . Discrepancy in impact of maternal milk on vertical transmission between hepatitis B virus and human cytomegalovirus[J ] . Int J Infect Dis, 2015, 37: 1-5. DOI: 10.1016/j.ijid.2015.06.002.

BZOWEJ N H. Optimal management of the hepatitis B patient who desires pregnancy or is pregnant[J]. Curr Hepat Rep, 2012, 11(2): 82-89. DOI: 10.1007/s11901-012-0130-x.

YIN Y Z, WU L L, ZHANG J, et al . Identification of risk factorsassociated with immunoprophylaxis failure to prevent the vertical transmission of hepatitis B virus[J ] . J Infect, 2013, 66(5): 447-452. DOI: 10.1016/j.jinf.2012.12.008.

马小艳, 孙继云, 蔡晧东. HBV感染母亲的血清病毒状态对新生儿HBV血清标志物的影响[J]. 中华实验和临床感染病杂志(电子版), 2014, 8(3): 352-355. DOI: 10.3877/cma.j.issn.1674-1358.2014.03.012.

MA X Y, SUN J Y, CAI H D. Effects of states of HBV infection in mothers' infected with hepatitis B virus on serum markers of HBV in neonates[J]. Chin J Exp Clin Infect Dis Electron Ed, 2014, 8(3): 352-355. DOI: 10.3877/cma.j.issn.1674-1358.2014.03.012.

WANG J S. Transformation of hepatitis B serologic markers in babies born to hepatitis B surface antigen positive mothers[J]. World J Gastroenterol, 2005, 11(23): 3582. DOI: 10.3748/wjg.v11.i23.3582.

崔恒春, 闫永平, 邵中军, 等. HBsAg阳性母亲的婴儿血乙型肝炎病毒标志物的动态变化[J]. 中华传染病杂志, 2009, 27(2): 118-122. DOI: 10.3760/cma.j.issn.1000-6680.2009.02.016.

CUI H C, YAN Y P, SHAO Z J, et al . Dynamic changes of hepatitis B virus markers in infants of HBsAg positive mothers[J ] . Chin J Infect Dis, 2009, 27(2): 118-122. DOI: 10.3760/cma.j.issn.1000-6680.2009.02.016.

SHAO Z J, ZHANG L, XU J Q, et al . Mother-to-infant transmission of hepatitis Bvirus: a Chinese experience[J ] . J Med Virol, 2011, 83(5): 791-795. DOI: 10.1002/jmv.22043.

王贵强, 王福生, 成军, 等. 慢性乙型肝炎防治指南(2015年版)[J]. 中国肝脏病杂志(电子版), 2015, 7(3): 1-18.

WANG G Q, WANG F S, CHENG J, et al . The guidelines of prevention and treatment for chronic hepatitis B: a 2015 upd ate[J ] . Chin J Liver Dis(Electr Version), 2019, 37(12): 711-736.

HUANG H Y, XU C Y, LIU L H, et al . Increased protection of earlier use of immunoprophylaxis in preventing perinatal transmission of hepatitis B virus[J ] . Clin Infect Dis, 2021, 73(9): e3317-e3323. DOI: 10.1093/cid/ciaa898.

WHITFORD K, LIU B, MICALLEF J, et al . Long-term impact of infant immunization on hepatitis B prevalence: a systematic review and meta-analysis[J ] . Bull World Health Organ, 2018, 96(7): 484-497. DOI: 10.2471/BLT.17.205153.

QAWASMI M, SAMUH M, GLEBE D, et al . Age-dependent decrease of anti-HBs titers and effect of booster doses using 2 different vaccines in Palestinian children vaccinated in early childhood[J ] . Hum Vaccin Immunother, 2015, 11(7): 1717-1724. DOI: 10. 1080/21645515.2015.1041687.

WANG C, WANG C, JIA Z F, et al . Protective effect of an improved immunization practice of mother-to-infant transmission of hepatitis B virus and risk factors associated with immunoprophylaxis failure[J ] . Medicine, 2016, 95(34): e4390. DOI: 10.1097/MD.0000000000004390.

YUE X, GE C, ZHUGE S, et al . Changes and analysis of anti-HBs titres after primary immunization in 1- to 16-year-old Chinese children: a hospital-based study[J ] . J Viral Hepat, 2018, 25(4): 373-380. DOI: 10.1111/jvh.12818.

YAN K, CAI W, CAO F, et al . Genetic effects have a dominant role on poor responses to infant vaccination to hepatitis B virus[J ] . J Hum Genet, 2013, 58(5): 293-297. DOI: 10.1038/jhg.2013.18.

JIANG M, ZHU B, YAO Q, et al . Anti-HBs levels in children under the age of two years born to HBV carrier mothers after immunoprophylaxis: a multicenter cross-sectional study[J ] . BMC Pediatr, 2021, 21: 492. DOI: 10.1186/s12887-021-02967-8.

李淑红, 岳亚飞, 赵小鸽, 等. Human Annexin Ⅴ在不同胎盘中的表达的定量分析[J]. 中国优生与遗传杂志, 2005, 13(10): 31-33. DOI: 10.3969/j.issn.1006-9534.2005.10.013.

LI S H, YUE Y F, ZHAO X G, et al . Quantification and expression of human annexin Ⅴ in kinds of placenta[J ] . Chin J Birth Heal Hered, 2005, 13(10): 31-33. DOI: 10.3969/j.issn.1006-9534.2005.10.013.

ARAKAWA K, TSUDA F, TAKAHASHI K, et al . Maternofetal transmission of IgG-bound hepatitis B e antigen[J ] . Pediatr Res, 1982, 16(3): 247-250. DOI: 10.1203/00006450-198203000-00017.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

SRSF1通过增加P53的稳定性抑制乙型肝炎病毒复制

干扰素诱导肝癌细胞ADAR1的表达模式及HBV复制抑制

从FDA批准药物库中筛选影响乙型肝炎病毒核衣壳形成的药物的初步研究