Effect of delivery mode on maternal- infant transmission of hepatitis B virus by immunoprophylaxis

Objective To study the effect of different delivery modes on immunoprophylaxis efficacy so as to clarify whether or not cesarean section reduces immunoprophylaxis failure. Methods Mothers with positive hepatitis B surface antigen (HBsAg) were selected in the third trimester of pregnancy. Their babies were inoculated with hepatitis B immunoglobulin at birth and hepatitis B vaccine at 1, 2 and 7 months of age. HBsAg and its antibodies (anti- HBs) were tested at 1, 4, 7, and 12 months of age, then followed up yearly. Results A total of 301 babies entered the study, including 144 born by normal spontaneous vaginal delivery, 40 by obstetric forceps or vacuum extraction, and 117 by cesarean section. The incidence of mother’s HBeAg positivity or baby’s gender constitution was comparable between the three groups. There were no significant differences in the positive rate of anti- HBs or HBsAg at follow- up periods among the three groups. At 12 months of age, anti- HBs could be detected in 78. 9% of the babies born by normal vaginal delivery, 84. 6% of the babies by forceps or vacuum extraction, and 86. 4% of the babies by cesarean section. The positive rate of HBsAg was 8. 1%, 7. 7%, 9. 7%, and chronic HBV infection incidence was 7. 3%, 7. 7%, 6. 8% respectively. Conclusions There are no significant effects of delivery mode on the interruption of HBV maternal- baby transmission by immunoprophylaxis. Cesarean section does not reduce the incidence of immunoprophylaxis failure.     

乙肝病毒转录体检测在母婴传播中的应用

目的探讨乙型肝炎病毒(HBV)转录体的检测在母婴传播中的意义。方法自母亲及其婴儿血清中提取核酸,经PCR及RT-PCR分别扩增HBVDNA和RNA,琼脂糖凝胶电泳显示产物,South-ern-blotting验证反应的特异性,取代表性产物克隆、测序。结果HBeAg(+)母亲的XDNA的表达(75.0%)和fRNA的表达(65.0%)显著高于HBeAg(-)的母亲(分别为37.5%和20.8%,P<0.05和P<0.005);所有表达fRNA的母亲也同时表达trRNA,在20例XDNA(-)、fRNA(-)的母亲中,仍有10例可检测到trRNA。新生儿XDNA的表达(4.6%)和fRNA的表达(6.8%)较其母亲显著降低;占优势表达的是trRNA(52.3%),且与其母亲trRNA的表达状态密切相关。母亲为trRNA(+)的新生儿trRNA的表达显著高于母亲为trRNA(-)者。15例HBsAb(+)的新生儿均未检出XDNA和fRNA,但11例仍可检测到trRNA。结论与HBVDNA及其表达产物相比,trRNA在HBV母婴垂直传播过程中有可能是一个出现更早期的可检测指标,它有助于更精确的确定新生儿HBV感染的状态。     

单纯疱疹病毒潜伏和激活机制研究进展

单纯疱疹病毒（HSV,包括HSV-1和HSV-2）是引起多种疾病的重要病原,通常这些疾病具有反复发作和无法根治的特点。HSV在外周黏膜组织表面进行增殖式感染后,可进入感觉神经元并建立无复制的潜伏感染。潜伏的病毒还可以通过激活的方式重新进入复制周期,并回到外周组织进行复发感染。这种既能通过潜伏逃避宿主免疫攻击又能在激活过程中传播的能力是该病毒高超的生存策略,也是当前任何药物无法彻底消灭该病毒的根本原因。虽然HSV潜伏与激活的研究众多,且不断有新的研究进展,但由于潜伏和激活过程本身的复杂性和研究模型的局限性,其中很多具体过程相关机制依然不明确,甚至常有争议。本文重点梳理HSV-1潜伏和激活的主要研究成果,并讨论其发展趋势。     

抗单纯疱疹病毒多克隆抗体治疗兔单纯疱疹病毒性角膜炎

目的:观察抗单纯疱疹病毒多克隆抗体(PcAb)治疗单纯疱疹病毒性角膜炎(HSK)的疗效.方法:对实验性单疱病毒角膜炎采用PcAb滴眼治疗,同时用无环鸟苷及盐水对照.结果:其临床疗效与病毒分离结果提示,角膜组织的病变程度明显减轻,并可抑制病毒向周围细胞扩散和缩小病灶范围.结论:PcAb作为一种新型生物制剂,为治疗HSK开辟了一条新途径.     

抗单纯疱疹病毒多克隆抗体治疗兔单纯疱疹病毒性角膜炎

目的 :观察抗单纯疱疹病毒多克隆抗体 ( Pc Ab)治疗单纯疱疹病毒性角膜炎 ( HSK)的疗效。方法 :对实验性单疱病毒角膜炎采用 Pc Ab滴眼治疗 ,同时用无环鸟苷及盐水对照。结果 :其临床疗效与病毒分离结果提示 ,角膜组织的病变程度明显减轻 ,并可抑制病毒向周围细胞扩散和缩小病灶范围。结论 :Pc Ab作为一种新型生物制剂 ,为治疗 HSK开辟了一条新途径。     

Antiviral effect of mangiferin and isomangiferin on herpes simplex virus.

Using tissue culture technique the present study for the first time indicated the antiviral effect of mangiferin and isomangiferin against type I herpes simplex virus (HSV-I). 4 methods were used for evaluating drug effectiveness (i.e., in vitro drug-on-virus direct action, simultaneous addition of drug-virus-inoculum to cell bottle, virus inoculation preceding drug addition, and drug addition followed by virus inoculation), it was readily found by log determination of HSV-I inhibition that isomangiferin somewhat exceeded such control drugs as acyclovir, idoxuridine, and cyclocytidine in log by 0.27-0.50, and that mangiferin was lower than isomangiferin in log by 0.53. The average plaque reduction rates of mangiferin and isomangiferin were 56.8% and 69.5% respectively. The antiviral effect of mangiferin and isomangiferin was presumably due to their capability of inhibiting virus replication within cells.

     

孕晚期使用乙肝免疫球蛋白对阻断乙肝病毒母婴传播的效果研究

目的:研究乙肝免疫球蛋白(HBIG)阻断乙型肝炎病毒(HBV)母婴传播的效果。方法:根据知情自愿原则,将本院2010～2011年度654例HBsAg阳性孕妇所分娩的新生儿分为实验组、对照组。实验组327例孕妇于妊娠28周起,每4周肌肉注射HBIG 200IU。对照组327例孕妇,不使用HBIG。两组新生儿均在出生后24h内各注射HBIG 100IU及乙肝疫苗,并于1,6个月龄肌肉注射乙肝疫苗。结果:12月龄时,实验组婴儿HBsAg阳性率(2.75%)低于对照组(6.42%),差异有统计学意义(P<0.05);抗-HBsAg阳性率实验组(87.46%)高于对照组(78.59%),差异有统计学意义(P<0.05)。结论:HBsAg阳性孕妇孕晚期使用乙肝免疫球蛋白能够降低乙肝病毒母婴传播率。     

2013-2016年性病门诊单纯疱疹病毒血清学检测结果分析

目的:分析性病门诊就诊者HSV-1和HSV-2的感染情况。方法:用ELISA法分别检测性病门诊就诊者2911例血清中HSV-1、Ⅱ型的IgM和IgG抗体。结果:2911例中,HSV-1、HSV-2,以及HSV-1和HSV-2混合感染率的95%可信区间分别为(65.04%~69.20%)、(0.20%~6.94%)、(14.01%~20.61%),HSV-1感染率高于HSV-2感染率和HSV-1和HSV-2混合感染率;HSV-1和HSV-2各年度检出率无统计学差异;男、女性HSV-1感染率分别为70.73%、55.07%,女性低于男性(χ~2=57.267,P=0.00);而HSV-2男、女性感染率分别为2.20%、5.07%,女性高于男性(χ~2=7.805,P=0.005);男、女性HSV-1和HSV-2混合感染率分别为13.16%、31.20%,女性高于男性(χ~2=117.127 P=0.00)。HSV-1和HSV-2既往/复发病例分别占83.68%和19.72%,HSV-1既往感染者相对较多。HSV-1和HSV-2的新发病例分别占1.38%和4.65%,HSV-2型新发感染者相对较多。结论:HSV在本地区性病门诊就诊者中具有较高感染率,应进一步在性病高危人群中采取干预措施,防止HSV通过性行为在本地蔓延流行。     

Neonatal herpes simplex virus infection occurring in second twin of an asymptomatic mother. Failure of a modern protocol

A case of neonatal herpes that occurred after vaginal delivery in the absence of genital lesions is presented. The mother had a history of drug addiction and genital herpes. Asymptomatic shedding of herpes simplex virus type 2 from the cervix was noted in the second trimester of pregnancy. Despite being followed with a protocol of close surveillance and serial culturing of the genital tract, the patient gave birth to twins, one of whom developed herpes simplex virus type 2 in the postpartum period. This report presents discussion of this case and herpes surveillance protocols.     

一株红树林真菌抗单纯疱疹病毒Ⅱ型的研究

目的 对分离自海南红树林真菌菌株PH1018的胞外多糖(Exopolysaccharide,EPS)抗单纯疱疹病毒Ⅱ型(Herpes simplex virus type 2,HSV-2)活性进行研究.方法 收集纯化菌株PH1018产生的EPS,体外采用细胞病变观察EPS的细胞毒性和抗HSV-2作用.为观察EPS对HSV-2体内感染的治疗效果,小鼠颅内注射0.02 ml滴度为100 LD50/0.1 ml-1的HSV-2,24 h后以不同浓度EPS灌胃,持续7d,14d后计算小鼠存活率和存活时间.菌株分类采用形态学观察和ITS序列分析.结果 EPS可抑制HSV-2病毒活性,病毒感染的细胞病变的半抑制浓度(Inhibited concentration,IC50)为313 μg/ml,SI为11.43.EPS 25 mg·kg-1·d-1灌胃后,小鼠存活率为40.0％,存活时间为(9.82±1.87)d,相比模型组实验动物存活时间和存活率均有提高.菌株初步鉴定为杂色曲霉.结论 从海南红树林分离一株杂色曲霉,其产生的EPS具有抗HSV-2活性,值得进一步研究.     

乙肝表面抗原阳性孕妇肌注乙肝免疫球蛋白预防母婴传播52例分析

①目的　探讨经母体对胎儿行被动免疫在预防乙型肝炎病毒 (HBV)宫内感染中的作用。②方法　对自孕 2 0周起多次肌注乙肝免疫球蛋白 (HBIG)的HBsAg(+)孕妇 52例 (A组 )及未注射的 32例HBsAg(+)孕妇 (B组 ) ,用固相放免法和套式PCR检测母血HBsAg、HBV -DNA及新生儿血HBsAg、抗HBs、HBV -DNA。③结果　A组 52例新生儿中 48例血清抗HBs(+) ,与B组相比具有显著差异 (P <0 .0 5)。A组新生儿血HBsAg、HBV -DNA检出率均明显低于B组。A组孕妇用药后血HBsAg滴度及HBV -DNA水平较用药前明显降低。④结论　经母体对胎儿行被动免疫可有效的预防HBV宫内感染     

大黄乙醇提取物对小鼠疱疹性脑炎的治疗作用

目的:研究中药大黄乙醇提取物对病毒性脑炎的治疗作用。方法:采用标准昆明鼠为动物模型,用单纯疱疹病毒I型(HSV-1)进行脑内局部接种,制成小鼠疱疹性脑炎模型,以无环鸟苷为阳性对照,用不同剂量的大黄乙醇提取物进行治疗。结果:大黄乙醇提取物可以显著提高疱疹性脑炎小鼠的存活率,延长平均存活时间,减轻脑组织的病理改变,明显消除脑内的病毒抗原,降低各个时期的病毒滴度。皮下注射给药3.3g/(kg·d)与4.9g/(kg·d)组效果优于无环鸟苷对照组。结论:中药大黄能有效地治疗由单纯疱疹病毒引起的脑炎,在体内有抗病毒作用,是一种有效的抗病毒中药,其在抗病毒领域的开发前景广阔。     

不同分娩方式对阻断乙型肝炎病毒母婴传播的影响

目的 探讨HBsAg和HBeAg双阳性孕妇其不同的分娩方式对乙型肝炎病毒母婴阻断效果的影响. 方法 将HBsAg和HBeAg双阳性的母亲所分娩的216例经同样的主被动免疫联合免疫接种后的婴儿,根据不同的分娩方式分为经阴道分娩组102例和剖宫产分娩组114例,采用电化学发光方法检测婴儿7月龄时外周静脉血的乙肝五项,比较两组的母婴阻断效果. 结果 102例阴道分娩的婴儿中有6例(5.9%)出现了阻断失败,96例阻断成功(94.1%);而114例剖宫产分娩的婴儿中有5例(4.4%)出现了阻断失败,99例阻断成功(95.6%),两组之间的阻断成功率和失败率无统计学差异(χ2=0.249,P=0.617). 结论 HBsAg和HBeAg双阳性孕妇所分娩的婴儿,经主被动免疫后,阴道分娩与剖宫产手术分娩两种分娩方式对母婴阻断效果无影响.     

宫颈单纯疱疹病毒感染的检测和分型

单纯疱疹病毒(HSV)分HSV-1和HSV-2两个血清型,两型病毒均能引起宫颈慢性炎症,并具有反复发作和致癌的特性,可对孕妇及围产儿造成严重后果．而且两型病毒的生物学特征及其引起的生殖器疱疹的病程和预后却不同．因此,对HSV感染的快速检测和准确分型,有助于生殖器疱疹的诊断、预后及流行病学研究．我们已建立了用于HSV检