孕妇血清、乳汁及新生儿脐血中输血传播病毒感染的研究

目的 了解输血传播病毒（TTV）在孕妇血清、乳汁及新生儿脐血中的感染状况,探讨TTV的传播途径。方法 用半巢式聚合酶链反应方法对150例孕妇血清、乳汁及新生儿脐血标本,进行TTV DNA扩增,对8例PCR阳性扩增产物再进行直接测序。结果 （1）150例孕妇血清TTV DNA的阳性率为11．3％（17／150）,17例孕妇血清TTV DNA阳性者中,乳汁阳性11例,其新生儿脐血均为阴性。（2）检测3例孕妇血清TTV DNA序列及乳汁TTV DNA序列,其核苷酸同源性为97．6％－99．2％;5例孕妇血清TTV DNA序列之间同源性为71．5％－92．8％,与日本原型株NSS的核苷酸及氨基酸序列同源性为71．5％－92．8％。结论 孕妇血清及乳汁中存在TTV感染,经乳汁传播可能是该病毒感染的主要方式之一。     

孕产妇输血传播病毒感染及其母婴传播的研究

目的 探讨输血传播病毒（TTV）在孕产妇中的感染状况及母婴传播途径。方法 应用半巢式聚合酶链反应技术检测104例孕产妇血清及其新生儿脐血的TTV DNA，并对两对母婴TTV阳性的TTV基因克隆后进行序列分析。结果 孕产妇TTV阳性率为13．46％（14／104）,新生儿脐血阳性率为4．81％（5／104）。两对母婴TTV序列片段（1915－2185核苷酸片段）分析发现，母血与脐血TTV基因序列的同源性均为100．00％。结论 孕产妇中存在TTV感染，并可能通过母婴传播的途径感染胎儿。     

孕妇乙型肝炎病毒携带状态与母婴传播的研究

目的 :探讨孕妇乙型肝炎 (乙肝 )病毒 (HBV)携带状态与母婴传播的关系。方法 :用荧光定量PCR法检测HBV表面抗原 (HBsAg)阳性孕妇血清中HBV脱氧核糖核酸(HBVDNA)及脐血HBVDNA ,婴儿出生后 1 2h内及第 1 4天注射乙肝免疫球蛋白 ,并按0、1、6的程序全程接种乙肝疫苗 ,进行前瞻性随访研究 ,分别于婴儿 7月及 1 2月时随访 ,检测HBVDNA及乙肝血清标志物 ,婴儿 7月时未感染乙肝但抗 HBs阴性者加强注射乙肝疫苗 5μg。 结果 :HBsAg、HBeAg及抗 HBc阳性孕妇的新生儿脐血HBVDNA阳性率为1 8.37% (9/ 4 9) ;HBsAg及HBeAg双阳性者为 1 2 .50 % (2 / 1 6) ;HBsAg及抗 HBc阳性者为1 2 .50 % (3/ 2 4 ) ;HBsAg,抗 HBe和抗 HBc阳性者为 1 .37% (1 / 73) ;脐血HBVDNA阳性的新生儿均生于HBVDNA阳性的母亲 ,阳性率为 1 8.52 % (1 5/ 81 ) ,不同HBV携带状态的脐血阳性率有统计学差异。总母婴传播率为 9.78%。结论 :孕妇HBV携带状态与母婴传播有关 ,孕妇血清HBeAg阳性或HBVDNA含量高是母婴传播的重要因素之一 ,孕妇血清HBVDNA阴性者母婴垂直传播的风险极小。在新生儿、婴儿接受被动及主动全程联合免疫的条件下 ,产时、产后HBV的母婴传播可以预防     

孕妇血清及乳汁中输血传播病毒DNA及其基因型检测的研究

目的 阐明孕妇输血传播病毒（TTV）感染状况、母婴传播方式和相关因素,并确定其基因型。方法 采用巢式聚合酶链反应（PCR）技术,分别检测160例孕妇血清和乳汁中的TIV DNA及其基因型。同时对其中乙型肝炎病毒（HBV）血清抗原／抗体标志物阳性与阴性者,进行血清和乳汁中的TTV DNA检测。结果 （1）160例孕妇的血清和乳汁中TTV DNA阳性率,分别为40．0％（64／160）和37．5％（60／160）。（2）其中HBV血清抗原／抗体标志物阳性116份,血清和乳汁中的TTV DNA阳性率分别为50．0％（58／116）和43．1％（50／116）;HBV血清抗原／抗体标志物阴性44份,血清和乳汁中TTV DNA的阳性率分别为13．6％（6／44）和22．7％（10／44）。HBV血清抗原／抗体标志物阳性者与阴性者TTV感染率比较,差异有显著性（P＜0．05）。（3）检测124例TTV DNA阳性孕妇血清或乳汁标本TTV DNA基因型均为Ⅰ型。结论 （1）孕妇中存在TTV感染,而HBV感染孕妇是TTV感染的高危人群,TTV感染途径与HBV传播具有相关性;（2）TTV可能通过母乳喂养传播;（3）孕妇中TTV DNA基因型以Ⅰ型为主。     

输血传播病毒母婴垂直传播的途径与机制研究

目的探讨输血传播病毒(transfusion transmitted virus,TTV)母婴垂直传播的途径和可能机制。方法采用地高辛标记探针,对36例产妇胎盘组织TTV DNA进行原位杂交定位检测。根据孕妇静脉血和胎儿脐血TTV DNA检测结果,将其胎盘组织标本分为以下三组:A组为两者均阳性12例;B组为孕妇阳性、胎儿阴性12例;C组为两者均阴性12例。结果TTV DNA阳性杂交信号呈蓝紫色团块状或颗粒状,位于感染细胞的细胞核内,偶见于细胞浆内。在36份胎盘组织标本中共有13份TTV DNA呈阳性,阳性率为36.1%。其中A组TTV DNA阳性8例(8/12),B组TTV DNA阳性5例(5/12),C组未检出TTV DNA。结论TTV可通过胎盘组织垂直传播进入胎儿血液,其传播机制属细胞源性母婴垂直传播。     

荧光定量PCR检测在人巨细胞病毒-IgM阴性婴儿巨细胞病毒感染诊断中的意义

目的探讨在人巨细胞病毒(HCMV)-IgM阴性情况下,联合尿液及乳汁HCMV-DNA荧光定量检测在婴儿巨细胞病毒感染诊断中的意义。方法选择2013年1月至2015年12月宜昌市中心人民医院儿科收治疑似HCMV感染患儿304例,根据患儿主诉及体格检查、临床第一诊断将疑似HCMV感染患儿分为肝炎组186例、肺炎组71例及其他组(主诉为发热、腹泻等)47例。分析各组患儿尿液及母乳的HCMV-DNA荧光定量PCR的结果。结果肝炎组和其他组尿液HCMV-DNA检出率分别为41.94%(78/186)、51.06%(24/47),显著低于母乳53.76%(100/186)、72.34%(34/47),差异有统计学意义(P0.05)。肺炎组尿液HCMV-DNA检出率与母乳比较差异无统计学意义(P0.05)。3组间尿液和母乳中HCMV-DNA阳性率比较差异无统计学意义(P0.05)。检出尿液与乳汁同时阳性88例(28.95%),乳汁阳性174例(57.24%),尿液阳性141例(46.38%)。结论母乳是婴儿HCMV感染的重要传染源,在患儿HCMV-IgM抗体阴性情况下,联合检测尿液及乳汁HCMV-DNA能提高检出阳性率,避免漏检。     

孕妇与胎儿巨细胞病毒感染的研究

目的 :探讨孕妇巨细胞病毒 (CMV)感染 ,早期诊断胎儿CMV感染。方法 :用酶联免疫法 (ELISA)和多聚酶链反应 (PCR)技术检测孕妇血中CMV特异性抗体及CMVDNA ,诊断孕妇CMV感染 ;检测羊水或脐血中CMVDNA诊断胎儿CMV感染。结果 :15 64例孕妇血清中CMV IgM阳性 2 9例 (占 1.8% ) ,CMV IgG阳性 130 6例 (83.5 % ) ,CMVDNA阳性 12 6例 (8.1% ) ;CMV IgM阳性者其CMVDNA均阳性。CMVDNA阳性的 12 6例孕妇其羊水或脐血中CMVDNA阳性 5 2例 (占 4 1.2 % ) ,CMV感染胎儿中有 5例胎儿畸形、2例死胎、3例IUGR ,出生时无明显症状的婴儿中 3例生后 1个月内患黄疸性肝炎 ,1例患新生儿肺炎。 1例发现室间隔缺损、2例出现单侧耳聋。结论 :孕妇CMV感染可造成胎儿严重危害 ,孕妇CMV感染后取羊水或脐血检测CMVDNA是诊断胎儿及新生儿CMV感染的最佳方法。     

553例产妇血清、乳汁、唾液中乙型肝炎病毒-DNA载量的检测及相关性研究

目的:探讨乙型肝炎病毒(HBV)携带产妇血清中HBV标志物感染模式(HBV-M)、HBV-DNA载量与乳汁、唾液中HBV-DNA阳性率的关系,为安全进行母乳喂养和母婴亲密接触提供循证医学依据。方法:选取467例HBV携带产妇(实验组,又分为大三阳组、小三阳组和单纯阳性组)和同期86例乙型肝炎五项指标全阴的产妇(对照组),用ELISA和实时荧光定量多聚酶链反应(PCR)方法,检测产妇血清HBV-M及血清、乳汁、唾液中HBV-DNA载量,分析乳汁、唾液中HBsAg阳性率、HBV-DNA阳性率与血清HBV-M的关系,以及乳汁、唾液HBV-DNA阳性率与血清HBV-DNA载量的相关性。结果:实验组中血清大三阳组,乳汁和唾液中HBsAg阳性率和HBV-DNA阳性率均明显高于小三阳组、单纯阳性组及对照组,两两比较差异均有高度统计学意义(P<0.01);实验组唾液HBsAg总阳性率与HBV-DNA总阳性率均高于乳汁(P<0.01);乳汁和唾液HBV-DNA阳性率与血清HBV-DNA载量呈正相关(r=0.976,P<0.01;r=0.999,P<0.01)。结论:血清大三阳产妇传染性较强;HBV携带产妇的唾液较乳汁更具有传染性;随着血清HBV-DNA载量的增加,乳汁、唾液中HBV-DNA阳性率增加,传染性增强。     

联合免疫后乙肝病毒携带产妇母乳喂养安全性的探讨

目的:探讨主被动联合免疫后乙肝病毒(HBV)携带产妇的婴儿接受母乳喂养的安全性。方法:前瞻性追踪115例孕晚期注射高效价乙肝免疫球蛋白(HB IG)的HBV携带产妇乳汁中HBV感染性标志物(HBVM)、HBV-DNA和新生儿外周血HBVM情况,以及接受联合免疫后母乳或人工喂养7月龄婴儿血HBVM情况。其中母乳喂养组婴儿70例,人工喂养组45例。结果:2组新生儿HBV感染率分别为11.4%和13.3%,2组婴儿母亲外周血HBeAg阳性率分别为31.4%和31.1%,差异均无统计学意义。母乳喂养组和人工喂养组产妇初乳中HBsAg阳性率分别为34.3%和40.0%,HBeAg阳性率分别为28.6%和26.7%,2组产妇初乳中HBsAg阳性率、HBeAg阳性率和HBV-DNA滴度比较,差异均无统计学意义。母乳喂养组和人工喂养组7月龄婴儿HBV感染率分别为5.7%和8.9%,抗HBs阳性率分别为85.7%和84.4%,2组比较差异均无统计学意义。结论:在进行多重联合免疫干预后,HBV携带产妇母乳喂养并不增加HBV母婴传播的风险。     

妊娠期人乳头瘤病毒感染对母儿影响的探讨

目的:探讨妇女妊娠期下生殖道人乳头瘤病毒(HPV)感染垂直传播及对婴儿的近期影响和母乳喂养与其传播的关系。方法:选择HPV感染的孕妇203例(研究组)和HPV阴性的正常孕妇(对照组)344例为研究对象,在分娩时取两组孕妇羊水、胎儿脐静脉血行HPV检测,做胎盘病理检查,并分析其母婴结局;同时对研究组新生儿的咽喉分泌物或外阴分泌物及产妇乳汁HPV进行检测,并随访产后半年和1年产妇乳汁HPV检测,及进行产后6月、12月、24月婴儿咽喉分泌物、外阴分泌物HPV检测。结果:①203例HPV阳性孕妇中,17例孕早、中期终止妊娠,余186例继续妊娠:阴道分娩89例(47.8%),剖宫产分娩97例(52.2%)。研究组胎膜早破、早产、胎儿生长受限、新生儿呼吸窘迫综合征、产后出血、产褥感染发生率与对照组相比,差异无统计学意义(P>0.05);②研究组分娩新生儿共186例,新生儿HPV感染128例,阳性率为68.8%。其中阴道分娩57例,剖宫产71例,两组比较差异无统计学意义(P>0.05);③研究组婴儿HPV转归:产后6个月婴儿HPV阳性率32.8%,产后12个月阳性率3.8%。产后两年复查,均转为阴性;④乳汁HPV检测:初乳...     

Mother-to-infant transmission of TT virus in Japan.

OBJECTIVE: The TT virus (TTV) was detected for the first time by Nishizawa and Okamoto et al. in 1997 in the serum of a patient with post-transfusion hepatitis of unknown origin (non-A-non-G type). TTV was subsequently, also found in the serum of blood donors with no history of blood transfusion, although at a lower rate than among donors with a history of blood transfusion. In the present study, we determined the percentage of TTV carriers among pregnant women with no history of blood transfusion, and evaluated the possibility of mother-child transmission. METHODS: Blood was sampled from 300 normal pregnant women with no history of blood transfusion, 10 infants born by vaginal delivery from TTV-positive women, 10 infants born by abdominal cesarean section from TTV-positive women at both 5 days and 3 months after birth, and 10 infants born from TTV-positive women at 6 months after birth. Amniotic fluid and breast milk were sampled from 10 and 30 TTV-positive women, respectively. Informed consent was obtained from all women before sampling. TTV DNA was detected by the nested polymerase chain reaction (PCR) method. RESULTS: (1) Of the 300 normal pregnant women with no history of blood transfusion, 60 (20%) were TTV-positive. (2) All infants from TTV-positive mothers were TTV-negative at both 5 days and 3 months after birth, regardless of whether they were born by vaginal delivery or abdominal cesarean section. (3) Of the 10 infants who were born from TTV-positive mothers and examined 6 months after birth, 4 (40%) were TTV-positive. (4) Amniotic fluid from all 10 TTV-positive women was TTV-negative. (5) Breast milk from 7 (23.3%) of the 30 TTV-positive women was TTV-positive. CONCLUSION: TTV was detected in 20% of pregnant women with no history of blood transfusion, suggesting that TTV infection can occur through non- blood-mediated routes. The possibility of transfer of TTV into amniotic fluid was ruled out due to its absence in amniotic fluid samples. All infants from TTV-positive women were TTV-negative at both 5 days and 3 months after birth, regardless of whether they were born by vaginal delivery or abdominal cesarean section, suggesting that infection in the parturient canal or the pelvis is unlikely. Because TTV was detected in breast milk from TTV-positive women and some of their infants were TTV-positive, breast milk was thought to be a mother-child infection route. These findings suggest that horizontal infection is more likely than vertical infection in mother-child transmission of TTV.     

Breast-feeding by a cyclosporine-treated mother

Background: Cyclosporine is known to be excreted in breast milk, but levels in infants are not known. Post-transplant breast-feeding has been contraindicated in mothers treated with calcineurin inhibitors such as cyclosporine.Case: A 35-year-old woman exclusively breast-fed her infant during the first 10.5 months of life while she was being treated with cyclosporine. Cyclosporine measurements in infant and maternal blood and breast milk revealed a mean breast milk/maternal blood level ratio of 84%, but undetectable levels in the infant. The infant grew and developed normally.Conclusion: The infant of a cyclosporine-treated mother was breast-fed exclusively during the first 10.5 months of life and did not absorb a detectable amount of the drug. Fetal growth and development were normal.     

Effects of levonorgestrel implant upon TSH and LH levels in male infants during lactation.

OBJECTIVES: The objective of the study is to evaluate the effects of levonorgestrel transferred through breast milk on thyroid stimulating hormone (TSH) and luteinizing hormone (LH) levels in full breast-fed infants. METHODS: Forty healthy postpartum women and their male newborns were recruited for the study. Women were randomly allocated to two study groups: Group 1, IUD users and group 2, Norplant users. Blood and milk samples were collected on the day of IUD or Norplant insertion and 3 and 6 months later for TSH and levonorgestrel measurements. RESULTS: The results disclosed a significant decrease in TSH levels, and a negative relationship between LNG levels and TSH concentration in breast feeding infants at 3 months after implant insertion. The lowest TSH levels were observed at 6 months in the women from group 2. CONCLUSIONS: The overall data indicate that the LNG levels transferred to fully breast-fed infants through breast milk from Norplant users significantly modified their TSH levels.     

A case of acquired zinc deficiency in a mature breast-fed infant

We describe a 5-month-old Japanese infant with zinc deficiency, who was exclusively breast-fed and showed improvement after zinc supplement was administered. His serum zinc level and the zinc content of breast milk from his mother were extremely low, although the mother's serum zinc level was within normal limits. Zinc deficiency would not be latently uncommon in a mature breast-fed infant.     

Hepatitis C — Role of Perinatal Transmission

Summary: To evaluate the role of perinatal transmission in the spread of hepatitis C virus (HCV), we screened a cohort of pregnant intravenous drug using (IVDU) women for HCV antibody detection; where seropositive HCV RNA detection by polymerase chain reaction (PCR) was found we followed the infants longitudinally for HCV antibody and HCV RNA. Serum prevalence for HCV for this population was 80% with HCV RNA detected in 50%. Recruitment and follow-up over a 3-year period of a cohort of 83 seropositive women, their 91 newborns and 16 siblings of newborns, showed that there had been a 3% perinatal transmission rate with 1 sibling also infected. These positive cases were defined as transient in 1 case (HCV RNA positive by PCR at 1 month, but seronegative and HCV RNA negative at 10 months of age), 2 unevaluable (HCV RNA positive at 2 months of age, but patients lost to follow-up), and 1 chronic infection in a child at 34 months (positive HCV RNA and seropositive 34-month sibling). Maternal HCV RNA levels for those with infected infants was a mean 40-fold greater than those whose babies were uninfected, although this did not reach statistical significance. Of the remaining infants, the majority (93%) had lost passively acquired maternal antibodies by 9 months of age and all by 12 months. Of 18 women who were HCV seropositive and breast feeding (66% of whom were HCV RNA positive in their sera), none had detectable HCV RNA in breast milk. Hence we conclude that transmission of HCV from mother to infant appears to be of low frequency and positivity appears to correlate with maternal circulating viral load.     

输血传播病毒母婴感染的前瞻性研究

目的 探讨孕产妇输血传播病毒（ＴＴＶ）感染率及其在母婴间的传播途径。方法 应用巢式聚合酶链反应（ｎ－ＰＣＲ）技术检测６０例健康孕产妇（观察组）静脉血ＴＴＶ,并对ＴＴＶ阳性产妇的乳汁及其新生儿脐血进行检测。并以２５１例健康非孕妇女（对照组）的ＴＴＶ感染情况作对照。结果 观察组ＴＴＶ感染率为２８．３３％,对照组ＴＴＶ感染率为７．７５％,两组比较差异有非常显著性（Ｐ〈０．０１）。观察组中ＴＴＶ阳性产妇乳     

A study on cytomegalovirus infection in 199 pregnant women and their infants

Cytomegalovirus (CMV) infection is common in human, and exerts harmful effects during pregnancy upon fetuses. In order to get a clear knowledge of CMV infection rate in pregnant women and their infants and of the relationship between maternal infection and congenital infection in our city, we tried to detect the CMV specific IgG and IgM in 199 paired serum samples of mother and infant. The results showed that 183 maternal serum samples and 179 umbilical cord serum samples were CMV-IgG positive, a positive rate of 92% and 90% respectively. While 6 maternal serum samples and 7 umbilical cord serum sample were CMV-IgM positive, a positive rate of 3.0% and 3.5% respectively. The close correlation of CMV-IgM levels between mothers and their babies indicates that the infant may acquire congenital infection from his CMV-IgM positive mother.