一项关于慢性乙型病毒性肝炎产妇HBV病毒载量与母乳喂养后婴儿乙肝五项的回顾性研究

A retrospective study of HBV viral load in women with chronic viral hepatitis B and five cases of hepatitis B in infants after breastfeeding

目的分析慢性乙型病毒性肝炎(CHB)产妇乙型肝炎病毒(HBV)病毒载量及母乳喂养后婴儿乙肝五项情况。方法回顾性分析本院住院分娩的CHB产妇80例及其出生婴儿的临床资料,分析产妇分娩前血清HBVDNA载量与婴儿满6个月时乙肝五项情况。结果80例产妇中,有41例(51.25%)HBVDNA阴性,39例(48.75%)HBVDNA阳性,其中HBV DNA低载量产妇有30例(37.50%),HBV DNA高载量产妇有9例(11.25%);80例出生婴儿中,有75例(93.75%)HBsAb阳性,1例(1.25%)HBsAg阳性,2例(2.50%)HBsAg+HBeAg+HBcAb阳性,2例(2.50%)五项全阴性。产妇HBV DNA阴性时,其出生婴儿的HBVM表现模式均为五项全阴性;产妇HBV DNA低载量与HBsAb阳性、HBsAg阳性、HBsAg+HBeAg+HBcAb阳性等模式有关;产妇HBV DNA高载量与HBsAb阳性和HBsAg+HBeAg+HBcAb阳性模式有关。在低载量HBVDNA阳性产妇中,有93.33%(28/30)出生婴儿呈HBsAb阳性;高载量HBV DNA阳性产妇中,有88.87%(8/9)出生婴儿呈HBsAb阳性。结论无论CHB产妇的HBVDNA载量较高或较低,采取母乳喂养后婴儿感染HBV的风险均较低,在采取免疫阻断措施的前提下进行母乳喂养仍有一定的安全性。

Objective To analyze the viral load of hepatitis B virus(HBV)in pregnant women with chronic viral hepatitis B(CHB)and five cases of hepatitis B in infants after breast-feeding.Methods The clinical data of 80 CHB parturients and their infants were retrospectively analyzed,and the serum HBV DNA load before delivery and the five conditions of hepatitis B when the infants were 6 months old were analyzed.Results Among the 80 parturients,41 cases(51.25%)were HBV DNA negative and 39 cases(48.75%)were HBV DNA positive,including 30 cases(37.50%)with low HBV DNA load and 9 cases(11.25%)with high HBV DNA load.Among the 80 infants,75 cases(93.75%)were HBsAb positive,1 cases(1.25%)was HBsAg positive,2 cases(2.50%)were HBsAg+HBeAg+HBcAb positive,and 2 cases(2.50%)were negative.When the maternal HBV DNA was negative,all five HBVM expression patterns were negative.Maternal HBV DNA low load was associated with HBsAb positive,HBsAg positive,and HBsAg+HBeAg+HBcAb positive.The high load of maternal HBV DNA was associated with HBsAb positive and HBsAg+HBeAg+HBcAb positive.93.33%(28/30)of HBsAb positive babies were bom in low load HBV DNA positive mothers.88.87%(8/9)of HBsAb positive babies were bom in high load HBV DNA positive mothers.Conclusion Whether CHB maternal HBV DNA load is higher or lower,the risk of HBV infection in infants after breast-feeding is lower,and breast-feeding under the premise of immunoblocking measures is still safe to some extent.