胚胎中HBV mRNA的表达与父婴传播关系的研究

Relationship between the expression of HBV mRNA in embryos and father-to-infant HBV transmission

目的:通过检测HBV感染父亲体外受精胚胎中的HBV mRNA以明确HBV父婴传播的意义。方法:以慢性HBV感染父亲体外受精后遗弃胚胎为研究对象,用单细胞RT-PCR检测胚胎中的HBV mRNA。结果:父亲HBV血清标志物阳性者而母亲为HBV血清标志物阴性的9例18个废弃胚胎,在1个胚胎中检测到HBVmRNA,阳性率为1/18(5.6%),84个阴性对照胚胎中未检出特异性HBV mRNA。随访发现实验组和阴性对照组之间临床妊娠率分别为33.3%和44.0%,两者之间差异无明显意义(P>0.05);早期流产率分别为33.3%和9.1%,两者之间无明显统计学意义(P>0.05);胚胎中HBV mRNA信号阳性父亲的体外受精胚胎成功种植,但发生了早期流产;两组均未发生子代HBV感染。结论:HBV mRNA的阳性结果证实了HBV可以通过精子进入早期卵裂胚胎并在其中复制,可能是父婴传播的主要途径;而且HBV可能会干扰胚胎的发育,进一步造成流产等不良结果。

Objective： To investigate father-to-infant transmission of hepatitis B virus （HBV） by detecting HBV mRNA in the IVF embryos with paternal HBV infection. Methods： We collected 18 discarded IVF embryos （9 cases） with paternal chronic HBV infection, and detected HBV mRNA in the embryos by single-cell RT-PCR. Results： HBV mRNA positive signals were found in 1 of the 18 embryos with paternal serum HBV positive markers （5.6%） , but no specific HBV mRNA signals were observed in the 84 embryos of the negative control group. Fallow-up visits revealed no significant difference between the experimental and negative control groups either in the rate of clinical pregnancy （ P 〉 0.05 ） or in that of early abortion （ P 〉 0.05 ）. The IVF embryo with paternal HBV mRNA positive signals was successfully implanted, but early abortion occurred. HBV infection was not transmitted to progeny in either of the two groups. Conclusion ： The positive resuhs of HBV mRNA indicate that HBV can get into early-cleavage embryos through sperm and replicate there, which may be the main channel of father-to-infant transmission. HBV may interfere with the development of embryos, and even result in abortion and other adverse outcomes.