产妇血清HBV DNA含量对乳汁和新生儿血清HBV DNA浓度的影响

Effect of Maternal Serum HBV-DNA Concentration on Breast Milk of Postpartum Women and Neonatus with Chronic HBV Infection

【目的】探讨乙型肝炎病毒携带产妇血清HBV DNA含量对乳汁和新生儿血清中HBV DNA含量的影响,以指导孕期处理和母乳喂养。【方法】选择乙型肝炎病毒携带产妇145例,采用荧光定量聚合酶链反应(FQ-PCR)技术对产妇血清、母乳和新生儿血清HBV DNA进行检测,并将产妇血清HBV DNA浓度分3级,分析产妇血清不同HBV DNA浓度级对乳汁及新生儿血清HBV DNA浓度的影响。【结果】血清HBV DNA<500copies/mL的产妇74例,乳汁中检出HBV DNA阳性为零,新生儿血清HBV DNA阳性1例;血清HBV DNA浓度为500～1.0×106copies/mL产妇30例,乳汁中检出HBV DNA阳性为3例,新生儿血清HBV DNA阳性1例;血清HBV DNA浓度为≥1.0×106copies/mL产妇41例,乳汁中检出HBV DNA阳性为36例,阳性率为87.8%,新生儿血清HBV DNA阳性仅3例。【结论】产妇血清中HBV DNA≥1.0×106copies/mL时,乳汁中HBV DNA阳性率大幅度增加,而当产妇血清HBV DNA浓度小于1.0×106copies/mL,乳汁中HBV DNA检出率极低。产妇血清HBV DNA浓度对宫内感染影响不大。

Objective To investigate the effect of maternal HBV-DNA concentration on that of the breast milk of postpartum and neonatus with chronic HBV infection.So as to guide the treatment during pregnancy and breast feeding.Methods HBV DNA levels in serum,breast milk,and neonatus serum were detected by fluorescent quantitative polymerase chain reaction in 145 postpartum women with chronic HBV infection.Serum HBV DNA was graded into three levels.The effect of different grade of maternal serum HBV DNA on the breast milk and neonate was analyzed.Result Seventy-four cases of maternal serum HBV DNA quantity were500 copies/mL,two of their breast milk HBV-DNA quantity were positive,one neonatal serum HBVDNA quantity was positive.Thirity cases of maternal serum HBV DNA quantity ranged of 500 ～ 1.0 × 106 copies/mL,3 cases showed positive in breast milk,one neonatal serum HBV-DNA quantity showed positive.Forty-one cases of maternal serum HBV DNA quantity were 1.0 × 106 copies/mL,the HBV DNA positive rate in breast milk reached to 87.8%（36 cases）,only three cases neonatus showed positive in there serum HBV DNA quantity.Conclusions When maternal serum HBV DNA quantity goes beyond 1.0 × 106 copies/mL,the HBV DNA positive rate in breast milk increases sharply,when serum HBV DNA quantity goes below 1.0 × 106 copies/mL,the HBV DNA positive rate in breast milk is very low.Maternal serum HBV DNA concentration has little effect on intrauterine infection.