摘要
目的了解乙型肝炎病毒(HBV)携带母亲所生婴儿HBV隐匿型感染的存在情况. 方法用ELISA法检测HBV携带母亲所生新生儿脐血中HBV标志物,筛选出118例HBsAg阴性/抗-HBc阳性脐血,用荧光定量PCR(FQ-PCR)和微粒子酶免技术(MEIA)对入选脐血作HBV DNA和HBsAg定量分析,并对这些高危新生儿进行随访检测. 结果 118例入选脐血中,36例(30.5%)HBV DNA载量≥5.0×102拷贝/ml,其中102～103拷贝/ml低滴度者25例(21.2%),104～105拷贝/ml中等滴度者11例(9.3%);同时有47例(39.8%)脐血HBsAg定量超过检测下限(S/N值≥2.00),其中浓度＜0.5ng/ml者27例(22.9%),0.5～5.0ng/ml者20例(16.9%);随访检测结果:出生时脐血HBV DNA阳性或(和)HBsAg浓度≥2.00(S/N,MEIA法)者,至6月龄和12月龄时血清HBV DNA和HBsAg(ELISA法)阳性率分别为84.8%、18.2%和78.1%、14.6%. 结论母亲为HBV携带者的高危新生儿用常规方法检测脐血HBsAg阴性,不能除外HBV宫内感染,而可能有部分存在HBV隐匿型感染,临床应采用更灵敏更可靠的检测技术并加强随访监测.
OBJECTIVE To know about the fact of occult HBV infection in infants born to HBV carrier mothers. METHODS A total of 118 cases of cord blood with HBsAg （-）/anti-HBc （＋） were picked out of the infants of HBV carrier mothers by ELISA analysis. The content of HBV DNA and HBsAg in these cases were detected by fluorescence quantitative PCR and microparticle enzyme immunoassay respectively. Most of the babies had been followed up for 12 months. RESULTS Thirty six cases with HBV DNA equal to or more than 5.0 × 10^2 copies/ml [30. 5% of 118 cases with HBsAg（-）/anti-HBc（＋）]included 25（21.2%） and 11（9.3%） with HBV DNA level equal to 10^2-10^3 copies/ml and 10^4-10^5 copies/ml, respectively. Forty seven cases with HBsAg equal to or more than 2.00S/N[39.8N of 118 cases with HBsAg（-）/anti-HBc（＋）]included 27（22.9%） and 20（16.9N） with HBsAg less than 0. 5ng/ml and 0. 5-5.0ng/ml, respectively. Among the 6 month old and 12 month old babies, the positive rate of HBV DNA and HBsAg（by ELISA） of groups with HBV DNA positive or/and HBsAg positive （by MEIA） in cord blood were 84.8% （28/33） and 18.2% （8/44）, 78.1% （25/32） and 14.6% （6/41）, respectively. CONCLUSIONS There are some cases of occult HBV infection in infants of HBV carrier mothers. It is necessary to improve the test sensitivity of HBV and to follow up the high-risk babies.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2005年第10期1100-1103,共4页
Chinese Journal of Nosocomiology
