乙型肝炎病毒垂直传播及其预防效果的调查

A Survey on Vertical Transmission of Hepatitis B Virus and the Effect of Prevention

目的:评估乙肝父婴传播及母婴传播情况及阻断效果。方法:以男方HBsAg阳性所生的7-24月龄的婴幼儿为父亲HBsAg阳性组,子女出生后均接种乙肝疫苗;女方HBsAg阳性所生的7-24月龄的婴幼儿为母亲HBsAg阳性组,子女出生后均在24h内注射乙肝免疫球蛋白并接种乙肝疫苗。分别检测父亲或母亲以及婴幼儿血清的乙肝标志物和HBV-DNA。结果:随访HBsAg阳性父亲及其小孩共117对,没有发现婴幼儿HBsAg阳性者,93名婴幼儿抗-HBs阳性,阳性率为79.5%(93/117);HBsAg阳性母亲及其婴幼儿共491对,14名婴幼儿HB-sAg阳性,母婴传播率2.9%(14/491),398名婴幼儿出现抗-HBs,阳性率为81.1%(398/491)。父亲或母亲HB-sAg阳性组之婴幼儿抗-HBs阳性率差异无显著性(χ2=0.769,P>0.05)。结论:本研究未发现乙型肝炎病毒父婴垂直传播;对新生儿采取主被动免疫方案后,HBV母婴传播率约为2.9%;经免疫后约20%子女抗-HBs阴性。

Objective. To estimate vertical transmission of hepatitis B virus （HBV） and the effect of pre- vention in central China. Methods. Infants whose fathers infected with HBV were received HBV vaccine and were followed at the age of 7-24 months. Infants whose mothers infected with HBV were received both HBIG and HBV vaccine and were followed at the age of 7-24 months. The parents and their children were tested for HBV-marker （HBV-M） and HBV-DNA. Results. None of the children whose father infected with HBV was HBsAg positive （0/117）, but 79.5% （93/ 117） were positive for anti-HBs. Fourteen children whose mothers infected with HBV were HB- sAg and HBV-DNA positive （14/491, 2.9%） and 81.1% （398/491） were positive for anti-HBs. There was no significant difference of anti-HBs rate between the two groups. Conclusion. Thisstudy found no evidence for vertical transmission from father to child. The mother-to-child trans- mission rate was 2.9% after passive and active immunization. About 20% of the children were anti-HBs negative after the immunization.