HBV前C基因突变及分型与HBV母婴传播关系的研究

Study on the relation between HBV pre-core mutation and types and HBV mother-infant transmission

目的探讨HBV(乙型肝炎病毒)前C基因突变、血清型及基因型分型与HBV母婴传播的关系。方法100份HBsAg阳性孕产妇及其新生儿的外周血,发生母婴传播血清为病例组,其他为对照组。ELISA法检测乙肝两对半,根据S基因判断HBV血清型和基因型。对HBV前C基因进行扩增及序列分析。结果99份HBV血清型全为adw型;39例发生母婴传播HBV基因C型25例;B型13例;E型1例。60例未发生母婴传播,HBV基因B型50例;C型10例。两组HBV基因分型结果差异有统计学意义(P<0.05)。39例发生母婴传播中27例发生了点突变,12例无任何突变,突变发生率为69%。结论HBV母亲C基因型可能更易发生母婴传播。HBV母婴传播中大多存在HBV前C基因变异并导致氨基酸取代,其中主要涉及丝氨酸、苏氨酸、酪氨酸等的磷酸化位点,这些重要位点氨基酸的取代可能在HBV母婴传播的发病中起作用。

Objective：To investigate the relation between HBV pre-core mutation and serotypes and genotypes and HBV mother-infant transmission. Methods：A total number of 100 serum samples were collected from mothers and infants,Which were divided into 2 groups：The serum samples with mother-infant transmission （case group） and the others（control group）. Hepatitis B marks were detected by ELISA. The serotypes and genotypes were analysed through HBV S gene. HBV pre-core gene sequences were amplified and were sequenced directly. Results：The HBV serotypes in 99 patients was all adw. Among 39 patients with mother-infant transmission,25 patients were genotype C,13 patients were genotypes B,1 patients was genotype E. Among 60 patients without mother-infant transmission,50 patients were genotype B,10 patients were genotype C. The genotypes had significant differences between the two groups（P〈0.05）. Among 39 patients with mother-infant transmission,27 patients had single nucleotide change in HBV pre-core gene,12 patients had not any mutation in HBV pre-core gene,the mutation rate was 69%.Conclusions：HBV genotype C might contribute to the mother-infant transmission. Single nucleotide changes in HBV pre-core gene were found in most patients with HBV mother-infant transmission. Most mutatins resulted in amino acid substitutions invovlving threonine,serine and tyrosine,which may play a role in the pathogenesis of HBV mother-infant transmission.