乙型肝炎病毒的水平传播和围产期传播

THE HORIZONTAL AND PERINATAL TRANSMISSION OF HEPATITIS B VIRUS INFECTION

在上海、河北、黑龙江和四川四省市调查了4 500名子女及其母亲的HBsAg阳性率。结果表明,HBsAg阳性母亲的子女,受水平和围产期传播的共同作用,其HBsAg阳性危险性显著高于单纯受水平传播作用的HBsAg阴性母亲的子女。HBsAg阴性母亲的74名HBsAg阳性子女,二年后11人转阴,年龄越大,阴转率呈越高的趋势,而HBsAg阳性母亲的31名阳性子女仅1例转阴,即后者的携带率(96.77％)高于前者(85.13％)。但就人群中HBsAg阳性和携带者的构成而言,仅32.25％的HBsAg的携带者,来源于受双重传播作用的HBsAg阳性母亲。换言之,水平传播的权重明显大于围产期传播,故阻断围产期传播的同时还应预防水平传播。

Investigation of HBsAg carrier rate in 4,500 children and their mothers, conducted collaboratively in four provinces and cities, indicate that children born to HBsAg positive mothers ran significantly higher HBsAg positive risk than those born to HBsAg negative mothers, because of the synergism of horizontal and perinatal transmission. The conversion rate of HBsAg positive to negative were 11 out of 74 among HBsAg positive children born to HBsAg negative mothers, as compared to 1 out of 31 HBsAg positive children born to HBsAg positive mothers. The chronic carrier rate ( 96.77% ) is higher in the latter than in the former group. The older the HBsAg positive children, the higher the conversion rate. However,the HBsAg chronic carriers of children of HBsAg positive mothers accounted for only 32.25% in the pool of carrier population. In other words, the weight of horizontal transmission is heavier than that of perinatal transmission. Obviously, when trying to block perinatal transmission we should also emphasize the necessity of preventing the horizontal transmission at the same time.