胚胎中HBV mRNA的表达与父婴传播关系的研究

目的:通过检测HBV感染父亲体外受精胚胎中的HBV mRNA以明确HBV父婴传播的意义。方法:以慢性HBV感染父亲体外受精后遗弃胚胎为研究对象,用单细胞RT-PCR检测胚胎中的HBV mRNA。结果:父亲HBV血清标志物阳性者而母亲为HBV血清标志物阴性的9例18个废弃胚胎,在1个胚胎中检测到HBVmRNA,阳性率为1/18(5.6%),84个阴性对照胚胎中未检出特异性HBV mRNA。随访发现实验组和阴性对照组之间临床妊娠率分别为33.3%和44.0%,两者之间差异无明显意义(P>0.05);早期流产率分别为33.3%和9.1%,两者之间无明显统计学意义(P>0.05);胚胎中HBV mRNA信号阳性父亲的体外受精胚胎成功种植,但发生了早期流产;两组均未发生子代HBV感染。结论:HBV mRNA的阳性结果证实了HBV可以通过精子进入早期卵裂胚胎并在其中复制,可能是父婴传播的主要途径;而且HBV可能会干扰胚胎的发育,进一步造成流产等不良结果。

Relationship between the expression of HBV mRNA in embryos and father-to-infant HBV transmission

Objective: To investigate father-to-infant transmission of hepatitis B virus(HBV) by detecting HBV mRNA in the IVF embryos with paternal HBV infection.Methods: We collected 18 discarded IVF embryos(9 cases) with paternal chronic HBV infection,and detected HBV mRNA in the embryos by single-cell RT-PCR.Results: HBV mRNA positive signals were found in 1 of the 18 embryos with paternal serum HBV positive markers(5.6%),but no specific HBV mRNA signals were observed in the 84 embryos of the negative control group.Follow-up visits revealed no significant difference between the experimental and negative control groups either in the rate of clinical pregnancy(P> 0.05) or in that of early abortion(P> 0.05).The IVF embryo with paternal HBV mRNA positive signals was successfully implanted,but early abortion occurred.HBV infection was not transmitted to progeny in either of the two groups.Conclusion:The positive results of HBV mRNA indicate that HBV can get into early-cleavage embryos through sperm and replicate there,which may be the main channel of father-to-infant transmission.HBV may interfere with the development of embryos,and even result in abortion and other adverse outcomes.