乙型肝炎病毒S基因变异株在母婴向的选择性传播

目的 探讨乙型肝炎疫苗和乙型肝炎免疫球蛋白联合免疫失败的婴儿血清中HBVS基因变异与母亲血清中HBV DNA含量的关系。方法　应用Roche公司的LightCycler定量分析仪测定95例母亲血清中HBV DNA含量,应用PCR技术对免疫失败的7例婴儿及其母亲血清进行扩增,扩增后克隆测序。结果95例婴儿中有7例（7.4％）出生后1年内发生HBV感染,其母亲血清中HBV DNA水平显著高于未发生感染组。对此7对母婴的序列分析,发现1对母婴婴儿的优势株为母亲的弱势株,另有1对发生婴儿131位苏氨酸到丙氨酸变异。结论免疫失败与母亲血清中高病毒血症相关,且母婴间存在选择性传播。

Selective transmission of hepatitis B virus variant with S gene mutation between HBV-carrier mothers and their infants

Objective To investigate the role of hepatitis B virus (HBV) DNA levels in HBV-carrier mother and selective transmission of HBV variant with S gene mutation to infant in the failure of neonatal HBV immunization. Methods Serum HBV DNA level was determined by Roche LightCycler quantities in 95 HBsAg-positive pregnant women and later in their newboms. Hepatitis B virus S gene sequences isolated from mother/child pairs were analyzed in 7 cases which did not respond to HBV vaccination and hepatitis B immunoglobulin. Results HBV infection was identified in 7.4% of the infants during their first year after birth. The levels of HBV DNA in the mothers of the infected infants were higher than those of the uninfected group, and selective transmission of HBV variant from mother to infant was observed. Conclusion HBV DNA levels in HBV-carrier mother and selective transmission of HBV variant from mother to infant contribute to the failure of neonatal HBV immunization.