慢性乙型肝炎产妇乳汁、血清HBV-DNA表达量与母乳喂养后婴儿乙肝标志物相关性分析

Correlation analysis of maternal milk,serum HBV-DNA expression levels and HBV markers in infants after breastfeeding with chronic hepatitis B

目的探讨慢性乙型肝炎产妇乳汁、血清HBV-DNA表达与母乳喂养后婴儿乙肝标志物相关性。方法选取CHB产妇92例,对比不同乳汁、血清HBV-DNA表达产妇母乳喂养前后婴儿乙肝标志物水平,分析乳汁、血清HBVDNA表达与母乳喂养后婴儿乙肝标志物关联性及CHB产妇母乳喂养后婴儿HBV感染因素。结果不同乳汁、血清HBV-DNA表达量CHB产妇感染状态差异有统计学意义(P <0.05);喂养12个月后,乳汁HBV-DNA载量> 103IU/ml者、血清HBV-DNA载量> 103IU/ml者婴儿HBsAg、HBsAb、HBeAg、HBeAb、HBcAb水平高于HBV-DNA载量≤103IU/ml者(P <0.05);乳汁HBV-DNA表达量、血清HBV-DNA表达与母乳喂养后婴儿HBsAg、HBsAb、HBeAg、HBeAb、HBcAb水平呈正相关(P <0.05);产妇乳汁、血清HBV-DNA表达量是母乳喂养后婴儿HBV感染的独立危险因素(P <0.05)。结论 CHB产妇乳汁、血清HBV-DNA表达与婴儿感染HBV关系密切,表达载量> 103IU/ml是婴儿感染HBV独立危险因素,临床需根据HBV-DNA表达指导喂养方式。

Objective To investigate the correlation between the maternal milk,expression of HBV-DNA in milk and serum of pregnant women with chronic hepatitis B and HBV markers in infants after breast feeding.Methods A total of 92 women with CHB were selected,the levels of HBV-DNA expression in different milks and serums before and after breastfeeding in babies were com pared,the expressions of HBV-DNA in breast milk and serum were analyzed for HBV markers in babies after breastfeeding and HBV infection factors in CHB mothers after breastfeeding.Results The levels of HBV-DNA in breast milk and serum were significantly different in CHB maternal infection status(P<0.05);after 12 months of feeding,the levels of HBsAg,HBsAb,HBeAg,HBeAb and HBcAb in infants with breast milk HBV-DNA load>10^3 IU/ml and serum HBV-DNA load>103 IU/ml were higher than those in infants with HBV-DNA load≤10^3 IU/ml(P<0.05);the levels of HBV-DNA in milk and serum HBV-DNA were positively correlated with the levels of HBsA,HBsAb,HBeAg,HBeAb,HBcAb in infants after breastfeeding(P<0.05);maternal milk and serum HBV-DNA expression were independent risk factors for infant HBV infection after breastfeeding(P<0.05).Conclusion The expressions of breast milk and serum HBV-DNA in CHB women are closely related to HBV infection in infants,the expression load>10^3 IU/ml is an independent risk factor for HBV infection in infants,and the clinical feeding method should be guided by HBV-DNA expression.