丙型肝炎病毒母婴宫内传播的研究

The study on maternal fetal transmission of hepatitis C virus

目的为研究丙型肝炎病毒（ＨＣＶ）的母婴宫内传播，评估ＨＣＶ母婴传播的危险性。方法应用酶联免疫吸附试验（ＥＬＩＳＡ）法检测ＨＣＶ，以逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）检测ＨＣＶ－ＲＮＡ。结果检测的４２７７例孕晚期孕妇血清抗－ＨＣＶ，其中６例阳性，进一步检查ＨＣＶ－ＲＮＡ，结果６例中有５例阳性，且均有受血史，５例阳性孕妇其配对婴儿脐血抗－ＨＣＶ均阳性，其中２例ＨＣＶ－ＲＮＡ阳性，肝功能异常；１例出生时ＨＣＶ－ＲＮＡ阴性，到２４个月时ＨＣＶ－ＲＮＡ阳转。ＨＣＶ母婴宫内传播率为２／５。结论表明上海地区存在ＨＣＶ母婴宫内传播，应重视有受血史的生育妇女孕期及孕前的ＨＣＶ检查及ＨＣＶ感染儿的随访。

Objective To study the maternal fetal transmission of hepatitis C virus (HCV) and to evaluate its risk.Methods Enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT PCR) techniques were used in this study. Results A total of 4 277 pregnant women were screened for their serum anti HCV antibody during the third trimester. Six pregnant women were anti HCV positive. HCV RNA was further detected using RT PCR technique. It was found that 5 out of 6 anti HCV seropositive women were HCV RNA positive and they all had history of blood transfusion. Five neonates born to HCV infected mother were also found to be anti HCV positive. Among them two were HCV RNA positive and had abnormal hepatic functions. One of those neonates who were HCV RNA negative at birth was found to be HCV RNA positive at 24 months of age. Therefore, the maternal fetal transmission rate of HCV was 2/5.Conclusion Maternal fetal transmission of HCV exists in Shanghai. It is necessary for all the child bearing aged women who had history of blood transfusion to have their serum HCV tested before conception and during pregnancy. Meanwhile, the infected neonates should be followed up.