HBsAg阳性产妇乳汁母婴传播的研究

The relative study of hepatitis B virus DNA in maternal blood and milk

目的:了解不同感染模式产妇血液、乳汁HBV-DNA感染状况,探讨乙型肝炎病毒(HBV通过母乳)母婴垂直传播的情况,为预防和阻断HBV-DNA的母婴传播提供依据。方法:对43例孕期无肝炎症状的HBsAg阳性母亲进行乙肝三对检测,并用荧光定量检测其静脉血、乳汁HBV-DNA含量,分析乳汁中HBV-DNA同孕妇乙肝标志物模式的关系和静脉血、乳汁HBV-DNA含量的相关性。结果:HBsAg和HBeAg同时阳性者乳汁中HBV-DNA检出率远高于HBeAg阴性组(P<0.001);乳汁HBV-DNA定量阳性的孕妇血HBV-DNA定量均为阳性,且两者含量的相关系数0.207(P=0.0275)。结论:HBsAg阳性产妇,若HBeAg或HBV-DNA定量为阳性,乳汁具有传染性的可能性较大,不宜哺乳;在孕妇血、乳汁HBV-DNA同时阳性标本发现HBV-DNA含量与乳汁中HBV-DNA之间成正相关。降低血中HBV-DNA含量,对降低和阻止通过母乳喂养的母婴垂直传播具有重要意义。若有条件,应检测乳汁HBV-DNA含量,这样更能直接了解乳汁传染情况,指导哺乳。

Objective:To investigate vertical transmitted infection of hepatitiees B virus(HBV) in serum and breast milk , in order to prevent and stop the transmission.Methods:HBV-DNA in venous Boodand breast milk were detected by FQ-PCR HBV-M in venous blood were also detected by ELISA in 43 HBsAg positive parturients.Results:The difference is significant between the value of venous HBV-DNA in HBeAg positive parturients and that in HBeAg negative parturients(P<0.001).The relative coefficient between the value of venous HBV-DNA and that of break milk HBV-DNA was 0.207 (P=0.0275) in both positive samples.Conclusion:The parturients with double positive of HBsAg and HBeAg are highly risk for breast feeding.Decrease HBV-DNA level in venous blood would be helpful to control vertical transmitted infection of hepatitis B virus. Detection of HBV-DNA in breast milk should be done for the mothers carried HBV in order to conduct break milking.