丙型肝炎病毒母婴传播的研究

Mother-to-infant transmission of hepatitis C virus

目的 :研究丙型肝炎病毒 (HCV )母婴传播机率及感染方式。方法 :用ELISA和RT PCR法检测母婴血清及母亲乳汁、羊水、唾液的抗 HCVIgG及HCV RNA ,循环测序法测定母婴HCV cDNA序列。 结果 :对 152 1例孕妇筛查 ,其中 15例抗 HCVIgG阳性 (12例HCV RNA阳性 )。所生 15例婴儿 ,随访结果仅 1例抗 HCVIgG持续阳性 ,出生时 2例血清HCV RNA阳性者中的 1例抗 HCVIgG及HCV RNA持续阳性。HCV母婴传播率为 16.7% (2 /12 )。其中一对母婴间HCV cDNA序列同源性为 10 0 %。羊水、乳汁、唾液抗 HCV及HCV RNA检出率分别为 10 0 %和 2 5.0 % ,53 .5%和 16.7% ,10 0 %和 0 .0 %。结论 :HCV母婴传播可能发生于宫内或分娩时 ,羊水可能是引起HCV母婴传播的重要因素 ,乳汁。

Objective: To investigate the possibility and the mecha ni sm of mother-to-infant transmission ofhepatitis C virus (HCV). Meth ods:Enzyme-linked immunosorbent assay(ELISA) was used to test anti-H CV antibody. HCV-RNA was tested by using reversed transcription polymerase chai n reaction(RT-PCR). HCV-cDNA sequences were tested by using Cycle Sequenci ng Reaction.Results:Fifteen infants and their mothers who wer e selected from 1 521 pregnant women (12 were positive with HCV-RNA) were foundto be positive with anti-HCV antibody and 2 of them were positive with HCV-RN A(16.7%) in 1 week after birth. HCV-cDNA sequences were identical between a mot her and her infant. During follow-up investigations, except one, anti-HCV anti body and HCV-RNA disappeared progressively within9 months in the infants. Thepositive rates of anti-HCV antibody and HCV-RNA in amnion fluid, breast milk,and saliva were respectively 100% and 25.0%,53.5% and 16.7%,100% and 0.0%. Conclusion:HCV is vertical transmitted from mother to infant witha percentage of 16.7%. It seemed likely that transmission occurs in utero or du ring delivery. Amnion fluid may play an important role in mother-to-infant tra nsmission. Breast milk and saliva seems to be less efficient in transmission.