HBV父婴垂直传播水平与HBV-DNA载量的相关研究

A correlation analysis between the rate of vertical transmission of HBV and HBsAg-positive father to infant and the rate of neonatal cord blood

目的探讨HBsAg阳性父亲血HBV-DNA的不同载量水平对其新生儿发生HBV父婴垂直传播的影响。方法对161例HBsAg阳性的父亲及其新生儿（母亲血清HBVM全阴性或仅HBsAb阳性及HBV-DNA均为阴性）HBV感染状况进行调查分析。采用ELISA检测HBVM，FQ－PCR法检测血清HBVDNA载量水平。结果（1）父亲血HBV-DNA载量水平与新生儿脐带血HBVDNA阳性存在剂量反应关系趋势（χ^2=64．117，P=0．000）。父亲血HBV-DNA≥1．0×10^7copies／ml组新生儿的HBV父婴垂直传播水平显著高于〈1．0×10^7copies／ml组（χ^2=71．539，P=0．000）；（2）HBeAg阳性组与HBeAg阴性组父亲其新生儿的HBV-DNA阳性率差异有统计学意义（χ^2=6．892，P=0．009）。结论父亲血清HBV-DNA载量水平与是否发生HBV父婴垂直传播密切相关，随血清HBV-DNA载量增加而上升，并存在影响传播的浓度界面；父亲血清HBV-DNA≥1．0×10^7copies／ml及HBeAg阳性是HBV父婴垂直传播的危险因素。

Objective To study the influence of HBV-DNA with different load levels of HBsAg-positive among fathers on the rate of neonatal cord blood HBV-DNA. Methods Using HBsAg and HBV-DNA as screening indicators for pregnant women and their husbands from an obstetric clinic. 161 pregnant women whose HBsAg and HBV-DNA were negative, but HBsAg was positive among their husbands and their newborns, were selected. Blood samples from those pregnant women, their husbands and their newborns were collected to detect the related indicators. Using ELISA to detect hepatitis B virus markers （HBVM）, and FQ-PCR to detect the levels of HBV-DNA load. According to neonatal cord blood HBV-DNA detection guideline, newborns with cord blood HBV-DNA positive were selected as cases, others as controls. Results （ 1 ） Result of the study showed that there was a dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive rates in newborns （trend χ^2= 64.117, P= 0.000）. The rate of vertical transmission of HBV from HBsAg-positive father to infant in the paternal serum HBV-DNA≥ 1.0 × 10^7 copies/ml group was significantly higher than HBV-DNA〈 1.0× 10^7 copies/ml group （ χ^2=71.539, P=0.000）. （2） There was a positive rank correlation between semen positive HBeAg and vertical transmission of HBV from HBsAg-positive father to infant （χ^2=6.892, P= 0.009）. Conclusion There was a dose- response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive in newborns. Paternal serum HBV-DNA ≥1.0 × 10^7 copies/ml and with HBeAg positive status were risk factors of vertical transmission of HBV from HBsAg-positive father to infant.