摘要
目的 分析前S1抗原(Pre-S1Ag)检测阴性的HBV感染孕妇血清学特征和前S1基因测序结果,为正确解释HBV感染孕妇中Pre-S1Ag检测无反应性和预防HBV垂直传播提供依据。方法 以2021年7月—2022年12月山东省妇幼保健院健康检查的孕妇为研究对象,检测乙肝五项和Pre-S1Ag,选取乙肝表面抗原(HBsAg)阳性而Pre-S1Ag阴性的标本为实验组共14例,随机选取HBsAg和Pre-S1Ag均阳性的标本为对照组20例,进行HBVDNA定量检测,并扩增PreS/S基因和测序。结果 HBV感染孕妇中Pre-S1Ag阴性仅在HBsAg、抗-HBe、抗-HBc三者均阳性的乙肝五项血清学模式中发现,占比4.17%,其他HBV感染血清学检测模式中未发现;实验组和对照组HBeAg、抗-HBe阳性率均存在显著差异(P <0.001);实验组与对照组比较,HBsAg检测结果分别为(29±91)IU/mL和(2070.6±714.8)IU/mL,HBV DNA定量结果分别为:(1.63±0.05)lgIU/mL和(5.79±1.53) lgIU/mL,差异均有统计学意义(P <0.001);测序结果显示:对照组中有3例B基因型,17例C基因型;实验组14例标本均为C基因型;两组前S1蛋白变异率差异无统计学意义(P>0.05)。结论 HBV感染孕妇中Pre-S1Ag无反应性与PreS基因变异并无相关性,而是与HBV DNA载量低导致Pre-S1Ag表达水平低于检测限有关。不能忽视Pre-S1Ag检测阴性的HBV感染孕妇发生垂直传播的可能性。
Objective The serological characteristics and preS1 gene sequencing in hepatitis B virus(HBV)infected pregnant women with negative Pre-S1 antigen(Pre-S1Ag)were analyzed to provide a basis for explaining the negative Pre-S1Ag in HBV-infected pregnant women and preventing vertical transmission.Methods Pregnant women who underwent health examination in Shandong Maternal and Child Health Hospital from July 2021 to December 2022 were selected as the study objects.Five tests of hepatitis B and Pre-S1Ag were detected.A total of 14 cases with positive hepatitis B surface antigen(HBsAg)and negative Pre-S1Ag were selected as the experimental group,and 20 cases with both positive HBsAg and Pre-S1Ag were randomly selected as the control group.HBV DNA was detected,and PreS/S gene was amplified and sequencing was performed.Results In HBV-infected pregnant women,Pre-S1Ag negative was found only in five serologic patterns of hepatitis B with positive HBsAg,anti-HBe and anti-HBC,accounting for 4.17%,but not in other serologic patterns of HBV infection.There were significant differences in the positive rates of HBeAg and anti-HBe between the experimental group and the control group(P<0.001).Compared with the control group,HBsAg detection were(29±91)IU/mL and(2070.6±714.8)IU/mL,respectively.HBV DNA were(1.63±0.05)lg IU/mL and(5.79±1.53)lg IU/mL,and the differences was statistically significant(P<0.001).The sequencing results showed 3 genotype B cases and 17 genotype C cases in the control group.The 14 samples in the experimental group were all genotype C.There was no significant difference in the positive rates of Pre-S1 protein between the two groups(P>0.05).Conclusion The no reactivity of Pre-S1Ag in HBV-infected pregnant women was not related to PreS gene mutations,but was related to the low HBV DNA load resulting in the expression level of Pre-S1Ag below the detection limit.The possibility of vertical transmission in HBV-infected pregnant women with negative Pre-S1Ag cannot be ignored.
作者
姜天琪
孙可望
王皓
黄象艳
JIANG Tianqi;SUN Kewang;WANG Hao(Shandong University of Traditional Chinese Medicine,250014)
出处
《临床输血与检验》
CAS
2023年第5期662-666,共5页
Journal of Clinical Transfusion and Laboratory Medicine
基金
山东省自然科学基金(No.ZR2020MH325)资助。
