文章摘要
武佳欣,杨志清,张睿君,李雁笛,赵甜静,扆琳珠,冯永亮,丰淑英,汪波,王素萍.HBsAg阳性母亲HBV核心启动子突变与宫内传播的关系[J].中华流行病学杂志,2020,41(6):902-907
HBsAg阳性母亲HBV核心启动子突变与宫内传播的关系
Relationship between mutations of HBV basal core promoter region in HBsAg-positive mothers and intrauterine transmission
收稿日期:2020-02-24  出版日期:2020-06-16
DOI:10.3760/cma.j.cn112338-20200224-00163
中文关键词: 乙型肝炎病毒宫内传播;核心启动子;HBs抗原;HBe抗原;A1762T/G1764A
英文关键词: Intrauterine transmission;Basal core promoter;HBsAg;HBeAg;A1762T/G1764A
基金项目:国家自然科学基金(81573212,81872677);传染病预防控制国家重点实验室自主研究课题(2017SKLID306,2018SKLID310)
作者单位E-mail
武佳欣 山西医科大学流行病学教研室, 太原 030001  
杨志清 山西医科大学流行病学教研室, 太原 030001  
张睿君 山西医科大学流行病学教研室, 太原 030001  
李雁笛 山西医科大学流行病学教研室, 太原 030001  
赵甜静 山西医科大学流行病学教研室, 太原 030001  
扆琳珠 山西医科大学流行病学教研室, 太原 030001  
冯永亮 山西医科大学流行病学教研室, 太原 030001 fengyongliang048@163.com 
丰淑英 山西省太原市第三人民医院妇产科 030001  
汪波 山西省太原市第三人民医院妇产科 030001  
王素萍 山西医科大学流行病学教研室, 太原 030001 spwang88@163.com 
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中文摘要:
      目的 分析HBV为C基因型的HBsAg阳性母亲核心启动子(BCP)区突变与宫内传播的关系。方法 2011年6月至2013年7月太原市第三人民医院妇产科HBsAg阳性母亲及新生儿399对。收集一般人口学资料,采用荧光定量PCR和电化学发光法分别检测母婴血清HBV DNA及HBV血清学标志物。选择HBV DNA载量≥106 IU/ml的113例母亲为研究对象,其新生儿发生宫内传播的22例为宫内传播组,随机选取其中22例未发生宫内传播者作为对照组,母亲HBV DNA经提取、扩增、克隆、测序和序列编辑及剪接后与从NCBI下载的标准序列比对进行基因分型,最终选择C基因型的39例母亲进行突变分析。结果 HBV为C基因型(88.63%)的母亲共39例,其中宫内传播组19例,对照组20例。母亲A1762T/G1764A双突变率在两组差异显著(7.53% vs.27.72%,P<0.001)。非条件logistic回归分析显示A1762T/G1764A双突变可能是宫内传播的保护因素(aOR=0.065,95% CI:0.006~0.746,P=0.028)。母亲A1762T/G1764A双突变可能与新生儿HBeAg水平有关(P=0.050)。结论 HBV C基因型的HBsAg阳性母亲HBV DNA BCP区A1762T/G1764A双突变可能降低HBV宫内传播的风险。
英文摘要:
      Objective To analyze the relationship between maternal mutations in basal core promoter region of hepatitis B virus (HBV) genotype C and intrauterine transmission. Methods We collected information on general demographic characteristics and process of delivery among 399 pairs of consecutive HBsAg-positive mothers and their neonates, from the Third People’s Hospital of Taiyuan in Shanxi province, China. Fluorescence quantitative polymerase chain reaction (FQ-PCR) and Electro-chemiluminescence immuno-assay (ECLIA) kits were used to detect both maternal and neonatal HBV DNA and serological markers in the peripheral blood. From 113 mothers with HBV DNA load ≥106 IU/ml, we selected 22 mothers whose neonates were with intrauterine transmission and randomly selected the same number of mothers whose neonates were without intrauterine transmission, as controls. The whole-length HBV DNA were extracted, amplified, cloned, sequenced and genotyped. Finally, a total of 39 mothers with genotype C of HBV were selected for mutation analysis. Results Thirty-nine cases of genotype C (88.63%) were finally included in the study, with 19 cases in the intrauterine transmission group and 20 cases as controls. Rates of A1762T/G1764A double mutations were significantly different between the intrauterine transmission group and the control group (7.53% vs. 27.72%, P<0.001). Results from the multivariate analysis showed that the A1762T/G1764A double mutations had reduced the risk of intrauterine transmission (aOR=0.065, 95%CI: 0.006-0.746, P=0.028). Maternal A1762T/G1764A double mutations appeared to be possibly associated with neonatal HBeAg (P=0.050). Conclusion A1762T/G1764A double mutations of HBV DNA from the genotype C of those HBsAg-positive mothers could reduced the risk of HBV intrauterine transmission during pregnancy.
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