新生儿脐带血HBV阳性的基因型溯源研究

Study on genotypes of neonates with positive HBV in umbilical cord blood

目的:探讨新生儿脐带血HBV阳性者的基因型,分析其基因型是来源于父亲、母亲还是混合感染。方法:选择在福建省妇幼保健院行产前检查的夫妇双方或者其中一方为HBsAg阳性的孕妇家庭,以新生儿脐带血HBV-DNA载量>500copies/ml的67个家庭作为研究对象进行HBV基因检测。分娩时收集新生儿脐带血进行HBVM、HBV-DNA载量、HBV基因型检测。结果:①新生儿脐带血HBsAg阳性率为52.2%(35/67);孕妇血清HBV-DNA阳性率为43.3%(29/67),HBsAg阳性率为55.2%(37/67);父亲血清HBV-DNA阳性率为74.6%(50/67),HBsAg阳性率为77.6%(52/67)。②从153例基因型检测追溯新生儿感染途径:父婴传播的40个家庭中,25个家庭为B型,10个家庭为C型,4个家庭为D型,1个家庭为B+C型;母婴传播的19个家庭为B型;未知感染来源的7个家庭夫妇及新生儿均为B型;混合感染1个家庭中父亲B型,母亲C型,新生儿B+C型。③C型的父亲血清HBV-DNA载量明显高于B型。结论:HBV基因分型以B型为主,C型次之,混杂少量D型及B+C型;新生儿HBV基因型可来源于父亲、母亲及混合感染;C型的父亲血清HBV-DNA载量明显高于B型。

Objective： To explore the genotypes of neonates with positive HBV in umbilical cord blood, analyze the resources of genotypes （fathers, mothers, and mixed infection） . Methods： The families with at least one family member with positive HBsAg who re- ceived prenatal examination in the hospital were selected ; and then 67 families with neonatal umbilical cord blood HBV - DNA load 〉 500 copies/ml were selected as study objects to conduct HBV gene detection; neonatal umbilical cord blood specimens were collected at birth to conduct HBVM, HBV- DNA load, HBV genotyping. Results： The positive rate of HBsAg in neonatal umbilical cord blood was 52. 2% （35/67） ; the positive rate of HBV - DNA in maternal serum specimens was 43.3% （29/67）, the positive rate of HBsAg was 55. 2% （37/ 67） ; the positive rate of HBV - DNA in paternal serum specimens was 741 6% （50/67）, the positive rate of HBsAg was 77.6% （52/67） ; the neonatal infection routes tracked based on 153 genotypes ： among 40 families of paternal - infantile transmission, 25 families were B type, 10 families were C type, 4 families were D type, 1 family was B ＋ C type; 19 families of maternal - infantile transmission were B type; 7 families of unknown infection source were B type ; one family of mixed infection were paternal B type, maternal C type, and neonatal B ＋ C type; the serum load of HBV - DNA in fathers with C type was significantly higher than that with B type. Conclusion： Among HBV geno- types, B type is the main type, followed by Ctype, D type and B ＋ C type are few; neonatal HBV genotypes may originate from fathers, mothers, and blended infections; the serum load of HBV - DNA in fathers with C type was significantly higher than that with B type.