乙型肝炎病毒宫内感染与围产期传播

本文报道95名慢性HBsAg携带母亲的婴儿发生HBV宫内感染与围产期传播的情况。分娩时收集所有新生儿24小时内的静脉血及部分婴儿3月与7月龄静脉血,分别检测HBsAg、抗-HBs、抗-HBc IgM和HBV-DNA。HBsAg和抗-HBs用SPRIA检测,抗-HBc IgM用ELISA法检测,HBV-DNA用斑点杂交法检测。
结果95名新生儿中仅2名系HBV宫内感染(2.1%),其中一名新生儿血HBsAg阳性,3月龄仍持续阳性;另一名为新生儿HBV-DNA阳性、7月龄HBsAg和HBeAg均阳转。95份新生儿血无一份抗-HBc IgM阳性。15名HBsAg携带母亲所生的婴儿中,其母亲HBeAg阳性的5名婴儿均在3月龄时HBsAg阳转;2名HBeAg和抗-HBe均阴性母亲的婴儿有一名获得了HBV感染;8名抗-HBe阳性母亲的婴儿仅2名HBV-DNA阳性母亲的婴儿感染了HBV。此结果表明抗-HBe和HBV-DNA同时阳性母亲的婴儿同样可以感染HBV,而抗-HBe阳性HBV-DNA阴性母亲的婴儿不会发生围产期感染。

The Intrauterine and Perinatal Transmission of Hepatitis B Virus from Carrier Mothers to Their Infants

A total of 95 infants born to HBsAg carriermothers were tested for the presence of HBsAg and anti-HBs by RIA, anti-HBc IgM by ELISA, and HBV-DNA by Southern blot hybridization in the venous blood samples taken in the first 24 hours after delivery. Meanwhile 15 infants born to HBsAg positive mothers were followed-up to observe the frequency of perinatal transmission.
The results of detection for HBsAg and HBV-DNA in all 95 venous blood samples from newborns at birth. Follow-up observation indicated that 2 infants might have intrauterine infection of HBV (2.1%). However all 95 newborn infants had no detectable anti-HBc IgM (tested by Abbott reagents).
Eight out of 15 infants born to chronic HBsAg carrier mothers were infected by HBV (53.33%) within seven months after birth. 5 infants born to HBeAg positive mothers became chronic HBsAg carriers. One of two infantsborn to mothers negative for HBeAg and anti-HBe became HBsAg positive at seven months and among 8 infants born to anti-HBe positive mothers 2 infants born to mothers positive for both anti-HBe and sera HBV-DNA acquired HBV infection.