妊娠合并乙型肝炎病毒感染产妇血清、唾液及乳汁HBV-DNA载量关系

HBV-DNA load in serum,saliva and milk of puerpera with HBV infection

目的:测定妊娠合并乙型肝炎病毒(HBV)感染产妇血清、唾液及乳汁中HBV-DNA载量,分析其指导意义。方法:选择2016年1月—2018年12月本院妊娠合并慢性乙型肝炎产妇,按乙型肝炎不同感染类型分组并比较组间产妇血清、唾液及乳汁中HBV-DNA载量,分析相关性。结果:大三阳组血清、唾液、乳汁中HBsAg及HBV-DNA阳性率最高(P<0.001),小三阳组与1+3/5阳性组血清、唾液中HBsAg及HBV-DNA阳性率无差异(P>0.05)、乳汁中阳性率低于唾液及血清(P<0.001)。大三阳组血清、唾液、乳汁中HBV-DNA载量≥1.0×109的比例高于小三阳及1+3/5阳性组,小三阳及1+3/5阳性组乳汁中HBV-DNA载量<1.0×10^5的比例高于唾液及血清(均P<0.05)。HBV感染产妇唾液、乳汁中HBV-DNA阳性率与血清HBV-DNA载量呈正相关(P<0.001)。结论:妊娠合并HBV感染产妇唾液及乳汁均具有传染性,其中乙肝大三阳传染性最强,且产妇的唾液传染性强于乳汁。

Objective:To detect the HBV-DNA load in serum,saliva and milk of puerpera with HBV infection,and to analyze its guiding significance in clinical practice.Methods:The puerpera with chronic hepatitis B virus(HBV)infection were selected in this study from January 2016 to December 2018,and they were divided into group A(puerpera with HBsAg,HBeAg,and Anti-HBc positive),group B(puerpera with HBsAg,Anti-HBe,and Anti-HBc positive),and group C(puerpera with HBsAg,and HBeAg or Anti-HBc positive)according to different clinical types of HBV infected.The HBV-DNA load in serum,saliva and milk HBV-DNA of women were compared among the three groups,and the correlation was analyzed.Results:The positive rates of HBsAg and HBV-DNA in serum,saliva and milk of the puerpera in group A were the highest(P<0.001).There were no significant different in the positive rates of HBsAg and HBV-DNA in serum and saliva of the puerpera between group B and C(P>0.05),but the positive rates of HBsAg and HBV-DNA in milk was significant lower than those in serum and saliva(P<0.001).The proportion of HBV-DNA load≥1.0×109 in the serum,saliva and milk of the puerpera in group A was significant higher than that of puerpera in group B and C(P<0.05).The proportion of HBV-DNA load<1.0×10^5 in the breast milk of puerpera in group B and C was significant higher than that in the saliva and serum(P<0.05).The positive rate of HBV-DNA in saliva and milk of puerpera with HBV infection was positive correlated with the HBV-DNA load in the serum(P<0.001).Conclusion:The HBV in saliva and milk of the puerpera with HBV infection has infectious,especially for the puerpera with HBsAg,HBeAg and Anti-HBc positive,and the infectious of HBV in saliva is more than that in milk.