摘要
目的 研究广州区乙型肝炎病毒(HBV)母婴宫内传播情况及HBV基因变异的特点。方法 新生儿接种重组乙肝疫苗(Hepatitis B vaccine,HBVac)24～48 h后采股静脉血。收集135份HBsAg阳性孕产妇及其139份新生儿外周血,为病例组;HBsAg阴性孕产妇25份及其新生儿外周血为对照组。检测所有标本HBV-DNA与:HBV血清标志物,对发生宫内感染的母婴血测序HBV S区,DNA SIS软件分析碱基变异及相应氨基酸变化特点。结果 新生儿HBsAg、HBV-DNA有一项阳性者7例,HBV宫内传播率为7/135(5.2％),宫内传播过程中母婴HBV-DNA的S区基因‘α’-决定簇内外均存在碱基改变,并导致一些氨基酸改变如126位Pro→Thr;142位Pro→Met,145位Gly→Arg,196位Trp→Leu/Ser等。结论 本地区HBV母婴宫内传播率低,宫内传播是出生后免疫失败的主要原因,而病毒碱基改变并不常见,与新生儿免疫失败关系并不密切。
Objective To study the intrauterine transmission of hepatitis B virus (HBV) in Guangzhou region and the characteristics of its molecular epidemiology of virus gene mutation. Methods Blood samples from 135 pregnant women with positive HBsAg or positive HBV-DNA and their 139 newborns (including 4 pairs of twins) were collected. Blood samples from another 25 pairs of mother and infants were obtained as controls. Serum HBV markers were assayed by ELISA,and S fragment of HBV-DNA (nt 401-833) by nested-PCR to detect the intrauterine infection. All the neonates with positive serum HBV-DNA were subsequendy investigated.Then,some PCR products (the infant blood from the infected mothers and the mother blood from control group) were cloned and sequenced,and the difference between them was analyzed. Results Seven neonates(5.2%) were found infected in uterus. Base alteration in gene a determinant of S fragment led to changes in main amino acid (AA), including 126 Pro→Thr, 142 Pro→ Met, etc. The 145 Gly→Arg, which is the most common in the immunized infected neonates,resulted in 145 Tyr→Phe. Conclusions The rate of HBV intrauterine infection in Guangzhou area is low.The infection is a cause for the failure of immunity in the neonates and babies. However, the base mutation and the AA change are not common, and they do not certainly lead to the immune failure.
出处
《武警医学》
CAS
2003年第12期727-729,共3页
Medical Journal of the Chinese People's Armed Police Force
