AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases wi...AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis ind展开更多
目的：探讨在妊娠晚期应用替比夫定阻断乙型肝炎病毒母婴传播的临床疗效和安全性。方法应用计算机检索中国生物医学文献数据库、万方医学数据库、中文科技期刊数据库、中国知网、PubMed、ISI web of knowledge、EMbase、Cochrane Librar...目的：探讨在妊娠晚期应用替比夫定阻断乙型肝炎病毒母婴传播的临床疗效和安全性。方法应用计算机检索中国生物医学文献数据库、万方医学数据库、中文科技期刊数据库、中国知网、PubMed、ISI web of knowledge、EMbase、Cochrane Library、BIOSIS Previews 等数据库，截止日期为2013年9月。参照纳入和排除标准进行文献筛选，采用 RevMan5.1软件进行Meta 分析。结果纳入文献11篇，共1241例孕妇，其中应用替比夫定602例，对照组639例；Meta 分析结果显示，随访6～12月龄婴儿，替比夫定组 HBsAg 和 HBV DNA 阳性率均低于对照组，差异有统计学意义[RR=0.15，95%CI（0.08，0.28），P＜0.00001；RR=0.12，95%CI（0.05，0.32），P＜0.0001]；替比夫定组孕妇分娩前 HBV DNA 水平低于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]；替比夫定组肌酸激酶升高率高于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]，应用替比夫定孕妇所产新生儿无畸形等并发症发生。结论替比夫定能阻断 HBV 宫内感染，其应用安全、有效。展开更多
Objective: To study intrauterine transmission of HBV and its cellular molecular mechanism and influence on the fetus. Methods.. A total of 46 coses of pregnant women who suffered from HBV were divided into HBeAg ( + )...Objective: To study intrauterine transmission of HBV and its cellular molecular mechanism and influence on the fetus. Methods.. A total of 46 coses of pregnant women who suffered from HBV were divided into HBeAg ( + ) and HBeAg ( -) groups. HBV-DNA in serum and peripheral blood mononuclear cells (PBMC-) of 46 cases of pregnant women before delivery was detected by polymerase chain reaction (PCR). After placenta being delivery, HBV-DNA in serum and cord blood mononuclear cells (CBMC) was also detected by PCR. Results.. The total of positive rates of HBV-DNA in serum and PBMC of pregnant women with hepatitis B were 69. 57% (32/46) and 41. 30% (19/46). The positive rates of HBV-DNA in serum of cord blood and CBMC were 56. 52%(26/46) and 21. 74% (10/46) respectively. Among them, the positive rates of HBV-DNA in serum and PBMC of pregnant women with HBeAg ( + ) were 100. 00% (25/25) and 60. 00% (15/25) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC were 88. 00% (22/25) and 32. 00% (8/25) respectively. The positive rates of HBV-DNA in serum and PBMC of pregnant women with HBeAg (-) were 33. 33% (7/21) and 19.05% (4/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC were 19. 05%(4/21) and 9. 52% (2/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC of newborns were higher in the group of pregnant women with HBeAg ( + ) than those in the group of pregnant women with HBeAg ( -) (P<0. 01 and P<0. 05). There was no HBV-DNA in serum, PBMC and CBMC of normal pregnant women and normal neonates. Conclusion: The intrauterine transmission of HBV can be existent and its transmission way not only can be induced by serum but also can be induced by PBMC. The way of intrauterine transmission of HBV induced by PBMC was concealed. The dangerous possibility of intrauterine transmission is higher in the pregnant women with HBeAg (+) than that in the group of pregnant women with HBeAg ( -).展开更多
Objective To investigate the relationship between maternal peripheral blood mononuclear cells (PBMC) hepatitis B virus(HBV) covalenty closed circular deoxyribonucleic acid(cccDNA) and other HBV serological markers and...Objective To investigate the relationship between maternal peripheral blood mononuclear cells (PBMC) hepatitis B virus(HBV) covalenty closed circular deoxyribonucleic acid(cccDNA) and other HBV serological markers and its effects on HBV intrauterine transmission. Methods We enrolled 290 newborns and their hepatitis B surface antigen(HBsAg) positive mothers. HBV cccDNA in PBMC and HBV DNA in serum were detected by a real‐time PCR‐TaqM an probe while HBV serological markers were detected with an electrochemiluminescence immunoassay. Results There was a positive correlation between the levels of PBMC HBV cccD NA and serum HBV DNA and HBeA g(r = 0.436 and 0.403, P < 0.001). The detection rate of pattern A [‘HBsA g(+), HBeA g(+), and anti‐HBc(+)’] was significantly higher in the PBMC HBV cccD NA positive group than in the control group(χ^2 = 48.48, P < 0.001). There was a significant association between HBV intrauterine transmission and PBMC HBV cccD NA(χ^2 = 9.28, P = 0.002). In the presence of serum HBV DNA, HBeA g, and PBMC HBV cccD NA, the risk of HBV intrauterine transmission was three times higher(OR = 3.69, 95% CI: 1.30‐10.42) than that observed in their absence. The risk of HBV intrauterine transmission was the greatest(OR = 5.89, 95% CI: 2.35‐14.72) when both PBMC HBV cccD NA and pattern A were present. A Bayesian network model showed that maternal PBMC HBV cccD NA was directly related to HBV intrauterine transmission. Conclusion PBMC HBV cccDNA may be a direct risk factor for HBV intrauterine transmission. Our study suggests that serological markers could be combined with PBMC‐related markers in prenatal testing.展开更多
目的系统评价乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)宫内注射阻断乙肝母婴传播的效果。方法计算机检索PubMed、e Cochrane Central Register of Controlled Trials(CENTRAL)、CNKI、VIP、CBM、WanFang Data数据库,查找HBIG...目的系统评价乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)宫内注射阻断乙肝母婴传播的效果。方法计算机检索PubMed、e Cochrane Central Register of Controlled Trials(CENTRAL)、CNKI、VIP、CBM、WanFang Data数据库,查找HBIG宫内注射阻断乙肝母婴传播的随机对照试验(RCT),检索时间均从1992年1月至2012年5月。对符合纳入标准的RCT,由两位评价员按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用STATA软件进行Meta分析。结果纳入42个RCT,共7 212例患者。尽管所有研究均声称"随机",但仅3个研究报告了随机方法。仅1个研究提及盲法,2个研究结果资料不完整,13个研究有其他类型的偏倚,均未报道分隐藏和选择性偏倚情况。Meta分析结果显示:新生儿出生时乙肝感染率试验组为8.971%,对照组为25.470%[RR=0.359,95%CI(0.303,0.425)],半年后试验组为5.385%,对照组为13.919%[RR=0.391,95%CI(0.278,0.550)],1年后试验组为5.318%,对照组为12.457%[RR=0.429,95%CI(0.335,0.551)];出生时抗体保护率试验组为61.964%,对照组为14.523%[RR=6.712,95%CI(1.920,23.467)],半年以上保护率试验组为77.754%,对照组为66.311%[RR=1.209,95%CI(0.989,1.478)]。倒漏斗图表明研究存在一定发表偏倚,敏感性分析表明除随访半年后乙肝抗体保护的研究结果较不稳定外,其余研究结果稳定性良好,与原合并效应值一致。结论乙肝携带孕妇宫内注射HBIG可降低新生儿出生、半年和1年时乙肝感染率,提高出生时抗体保护率,但对提高半年以上抗体保护率无效。由于纳入研究方法学质量欠佳,存在偏倚,对上述结论的临床应用应谨慎。展开更多
基金Supported by the office of Science and Technology of Xinjiang,No.960505003
文摘AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis ind
文摘目的：探讨在妊娠晚期应用替比夫定阻断乙型肝炎病毒母婴传播的临床疗效和安全性。方法应用计算机检索中国生物医学文献数据库、万方医学数据库、中文科技期刊数据库、中国知网、PubMed、ISI web of knowledge、EMbase、Cochrane Library、BIOSIS Previews 等数据库，截止日期为2013年9月。参照纳入和排除标准进行文献筛选，采用 RevMan5.1软件进行Meta 分析。结果纳入文献11篇，共1241例孕妇，其中应用替比夫定602例，对照组639例；Meta 分析结果显示，随访6～12月龄婴儿，替比夫定组 HBsAg 和 HBV DNA 阳性率均低于对照组，差异有统计学意义[RR=0.15，95%CI（0.08，0.28），P＜0.00001；RR=0.12，95%CI（0.05，0.32），P＜0.0001]；替比夫定组孕妇分娩前 HBV DNA 水平低于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]；替比夫定组肌酸激酶升高率高于对照组，差异有统计学意义[MD=-3.86，95%CI（-4.55，-3.16），P＜0.00001]，应用替比夫定孕妇所产新生儿无畸形等并发症发生。结论替比夫定能阻断 HBV 宫内感染，其应用安全、有效。
基金Supported by the Grants from Science Foundation of the Ministry of Coal Industry of P.R.China
文摘Objective: To study intrauterine transmission of HBV and its cellular molecular mechanism and influence on the fetus. Methods.. A total of 46 coses of pregnant women who suffered from HBV were divided into HBeAg ( + ) and HBeAg ( -) groups. HBV-DNA in serum and peripheral blood mononuclear cells (PBMC-) of 46 cases of pregnant women before delivery was detected by polymerase chain reaction (PCR). After placenta being delivery, HBV-DNA in serum and cord blood mononuclear cells (CBMC) was also detected by PCR. Results.. The total of positive rates of HBV-DNA in serum and PBMC of pregnant women with hepatitis B were 69. 57% (32/46) and 41. 30% (19/46). The positive rates of HBV-DNA in serum of cord blood and CBMC were 56. 52%(26/46) and 21. 74% (10/46) respectively. Among them, the positive rates of HBV-DNA in serum and PBMC of pregnant women with HBeAg ( + ) were 100. 00% (25/25) and 60. 00% (15/25) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC were 88. 00% (22/25) and 32. 00% (8/25) respectively. The positive rates of HBV-DNA in serum and PBMC of pregnant women with HBeAg (-) were 33. 33% (7/21) and 19.05% (4/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC were 19. 05%(4/21) and 9. 52% (2/21) respectively. The positive rates of HBV-DNA in serum of cord blood and CBMC of newborns were higher in the group of pregnant women with HBeAg ( + ) than those in the group of pregnant women with HBeAg ( -) (P<0. 01 and P<0. 05). There was no HBV-DNA in serum, PBMC and CBMC of normal pregnant women and normal neonates. Conclusion: The intrauterine transmission of HBV can be existent and its transmission way not only can be induced by serum but also can be induced by PBMC. The way of intrauterine transmission of HBV induced by PBMC was concealed. The dangerous possibility of intrauterine transmission is higher in the pregnant women with HBeAg (+) than that in the group of pregnant women with HBeAg ( -).
基金supported by grants from the National Natural Science Foundation of China [81573212,81872677]Open Project Support by the State Key Laboratory of Infectious Disease Prevention and Control [2017SKLID306,2018SKLID310]
文摘Objective To investigate the relationship between maternal peripheral blood mononuclear cells (PBMC) hepatitis B virus(HBV) covalenty closed circular deoxyribonucleic acid(cccDNA) and other HBV serological markers and its effects on HBV intrauterine transmission. Methods We enrolled 290 newborns and their hepatitis B surface antigen(HBsAg) positive mothers. HBV cccDNA in PBMC and HBV DNA in serum were detected by a real‐time PCR‐TaqM an probe while HBV serological markers were detected with an electrochemiluminescence immunoassay. Results There was a positive correlation between the levels of PBMC HBV cccD NA and serum HBV DNA and HBeA g(r = 0.436 and 0.403, P < 0.001). The detection rate of pattern A [‘HBsA g(+), HBeA g(+), and anti‐HBc(+)’] was significantly higher in the PBMC HBV cccD NA positive group than in the control group(χ^2 = 48.48, P < 0.001). There was a significant association between HBV intrauterine transmission and PBMC HBV cccD NA(χ^2 = 9.28, P = 0.002). In the presence of serum HBV DNA, HBeA g, and PBMC HBV cccD NA, the risk of HBV intrauterine transmission was three times higher(OR = 3.69, 95% CI: 1.30‐10.42) than that observed in their absence. The risk of HBV intrauterine transmission was the greatest(OR = 5.89, 95% CI: 2.35‐14.72) when both PBMC HBV cccD NA and pattern A were present. A Bayesian network model showed that maternal PBMC HBV cccD NA was directly related to HBV intrauterine transmission. Conclusion PBMC HBV cccDNA may be a direct risk factor for HBV intrauterine transmission. Our study suggests that serological markers could be combined with PBMC‐related markers in prenatal testing.
文摘目的系统评价乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)宫内注射阻断乙肝母婴传播的效果。方法计算机检索PubMed、e Cochrane Central Register of Controlled Trials(CENTRAL)、CNKI、VIP、CBM、WanFang Data数据库,查找HBIG宫内注射阻断乙肝母婴传播的随机对照试验(RCT),检索时间均从1992年1月至2012年5月。对符合纳入标准的RCT,由两位评价员按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用STATA软件进行Meta分析。结果纳入42个RCT,共7 212例患者。尽管所有研究均声称"随机",但仅3个研究报告了随机方法。仅1个研究提及盲法,2个研究结果资料不完整,13个研究有其他类型的偏倚,均未报道分隐藏和选择性偏倚情况。Meta分析结果显示:新生儿出生时乙肝感染率试验组为8.971%,对照组为25.470%[RR=0.359,95%CI(0.303,0.425)],半年后试验组为5.385%,对照组为13.919%[RR=0.391,95%CI(0.278,0.550)],1年后试验组为5.318%,对照组为12.457%[RR=0.429,95%CI(0.335,0.551)];出生时抗体保护率试验组为61.964%,对照组为14.523%[RR=6.712,95%CI(1.920,23.467)],半年以上保护率试验组为77.754%,对照组为66.311%[RR=1.209,95%CI(0.989,1.478)]。倒漏斗图表明研究存在一定发表偏倚,敏感性分析表明除随访半年后乙肝抗体保护的研究结果较不稳定外,其余研究结果稳定性良好,与原合并效应值一致。结论乙肝携带孕妇宫内注射HBIG可降低新生儿出生、半年和1年时乙肝感染率,提高出生时抗体保护率,但对提高半年以上抗体保护率无效。由于纳入研究方法学质量欠佳,存在偏倚,对上述结论的临床应用应谨慎。
