HBV标志物评价母婴免疫阻断效果的研究进展

Research progress in utilization of HBV markers in evaluating the effect of immunoprophylaxis in infants born to mother with positive HBs Ag

感染HBV时的年龄是影响HBV慢性化的主要危险因素,故及早判断HBV母婴阻断效果非常重要。综述了HBV血清学及病毒学标志物评价母婴阻断效果的研究,提示出生时HBs Ag高滴度(>250 IU/ml)、HBV DNA高载量(>105IU/ml)、HBe Ag持续阳性1个月以上以及1月龄时抗-HBs阴性(<10 m IU/ml)可预示婴儿发生慢性HBV感染的高风险性。此外,近年有文献报道部分免疫后婴儿虽然HBs Ag阴性,但HBV DNA阳性即发生HBV隐匿性感染,提示若条件允许,HBs Ag阳性母亲所生婴儿免疫阻断后除HBV血清学标志物外应进一步检测HBV DNA。

Since age at hepatitis B virus（ HBV） infection is a major risk factor associated with the chronicity of HBV,it is of great importance to evaluate the effect of immunoprophylaxis as early as possible in the mother- to- child transmission. This review focuses on HBV serologic and virologic markers in evaluating the effect of immunoprophylaxis in infants born to mother with positive HBV surface antigen（ HBs Ag） and indicates that HBs Ag 250 IU/ml,HBV DNA 105 IU / ml at birth,HBV e antigen（ HBe Ag） being continuously positive for one month,and HBVs antibody（ anti- HBs） being negative（ 10 m IU / ml） at one month of age are good indicators of chronic HBV infection in infants. Additionally,several recent studies reported that some babies born to HBs Ag- positive mothers could have occult HBV infection（ positive HBV DNA） despite their HBs Ag negativity after vaccination. Thus,in addition to the HBV serologic markers,HBV DNA should be detected when evaluating the effect of immunoprophylaxis in infants born to mother with positive HBs Ag,if conditions allow.