HBsAg阳性慢性HBV携带者孕妇血清HBV DNA载量水平与新生儿HBV感染及细胞因子的相关性

Association between serum HBV-DNA load of HBsAg-positive pregnant women carrying with chronic HBV and HBV infection,cytokines in neonates

目的探究乙型肝炎病毒表面抗原(HBsAg)阳性慢性乙型肝炎病毒(HBV)携带者孕妇血清HBV DNA载量水平与新生儿HBV感染和辅助性T细胞1(Th1)、辅助性T细胞2(Th2)细胞因子的关系。方法选取2018年1月-2020年12月连云港市东方医院收治的HBsAg阳性慢性HBV携带者孕妇120例,比较不同血清HBV DNA载量水平孕妇的新生儿HBV感染率,检测孕妇外周血Th1、Th2型细胞因子水平,受试者工作特征(ROC)曲线分析Th1、Th2型细胞因子水平对新生儿HBV感染的评估价值。结果HBV DNA高载量组孕妇新生儿HBV感染率高于低载量组和中载量组(P<0.05);新生儿感染HBV孕妇白细胞介素(IL)-2、γ-干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)水平低于新生儿HBV未感染孕妇(P<0.05),IL-4、IL-6、IL-10水平高于新生儿HBV未感染孕妇(P<0.05)。ROC曲线分析显示,Th1、Th2型细胞因子水平评估新生儿HBV感染的曲线下面积(AUC)较大。结论HBsAg阳性慢性HBV携带者孕妇HBV DNA载量水平越高,新生儿HBV感染风险越高,Th1/Th2平衡向Th2优势应答趋势发展。

OBJECTIVE To explore the relationship between the serum HBV DNA load of hepatitis B virus surface antigen(HBsAg)-positive pregnant women carrying with chronic hepatitis B virus(HBV)and HBV infection,cytokines helper T cell 1(Th1)and helper T cell 2(Th2)in neonates.METHODS A total of 120 HBsAg-positive pregnant women who carried with chronic HBV and were treated in Lianyungang East Hospital from Jan 2018 to Dec 2020 were enrolled in the study.The incidence of HBV infection in neonates was compared among the pregnant women with different serum HBV DNA load,the levels of peripheral blood Th1 and Th2 of the pregnant women were detected,and the values of Th1 and Th2 in assessment of neonatal HBV infection were analyzed by receiver operating characteristic(ROC)curve.RESULTS The incidence of neonatal HBV infection was significantly higher in the high HBV DNA load group than in the low load group and the medium load group(P<0.05).The levels of interleukin(IL)-2,interferon-gamma(IFN-γ)and tumor necrosis factor alpha(TNF-α)of the pregnant women with neonatal HBV infection were significantly lower than those of the pregnant women without neonatal HBV infection(P<0.05);the levels of IL-4,IL-6 and IL-10 of the pregnant women with neonatal HBV infection were significantly higher than those of the pregnant women without neonatal HBV infection(P<0.05).ROC curve analysis showed that the areas under curves(AUCs)of Th1 and Th2 were large in assessment of neonatal HBV infection.CONCLUSION The higher the HBV DNA load of the HBsAg-positive pregnant women carrying with HBV,the higher the risk of the neonatal HBV infection.The Th1/Th2 balance shows a Th2 dominated response trend.