HBsAg阳性产妇血清及乳汁HBV-DNA定量分析及应用

目的 为选择方便、准确的方法定量检测产妇血清及乳汁HBV-DNA的含量,依据两项检测结果特别是乳汁中乙型肝炎病毒载量,指导母乳喂养.方法 选择HBsAg阳性的产妇232例,采用实时荧光定量聚合酶链反应法检测产妇血清及乳汁HBV-DNA的含量.结果 232例血清HBsAg阳性产妇血清HBV-DNA阳性177例,据血清HBV-DNA的含量,分≥105 copy/ml和＜105 copy/ml两组,两组乳汁HBV-DNA阳性符合率分别为为54.4%和14.9%,两组比较差异有统计学意义（P＆lt;0.01）.血清HBV-DNA阴性者乳汁HBV-DNA均阴性,血清HBV-DNA阳性者乳汁HBV-DNA总阳性符合率为37.9%.结论 血清HBV-DNA定量检测阳性的产妇其乳汁中HBV-DNA检测阳性的占较大比例,且乳汁中HBV-DNA含量与血清病毒含量成正比.检测HBV感染产妇乳汁中HBV-DNA含量,对阻断母婴传播,为HBV感染产妇选择是否母乳喂养提供了指导依据.

HBV-DNA quantitative analysis and application in HBsAg-positive maternal serum and milk

Objective To choose a convenient, and accurate method for determining levels of HBV-DNA in the parturient maternal sernm and the milk, and provide a hreastfeeding guidance based on two test results, espeeiaUy hepatitis B viral load in breast milk. Methods In two hundred and thirty-two HBsAg-positive parturient women, leve/s of HBV-DNA of maternal serum and the milk were detected using real-time fluorescence quantitative polymerase chain reaction method（FQ-PCR）. Results In the 232 serum HBsAg-positive parturient women, there were 177 ser- um HBV-DNA positive women. According to the content of serum HBV-DNA these patients were divided into ≥ 10^5 eopy/ml and 〈 10^5 eopy/ml groups, their milk HBV-DNA positive rate was 54. 4% and 14. 9% respeetively, there was highly significant difference between two groups （P 〈 0. 01 ）. In serum HBV-DNA negative women, HBV-DNA in milk were negative;in serum HBV-DNA positive women the milk HBV-DNA positive rate was 37.9%. Conclusion Serum HBV-DNA positive parturient women have a higher milk HBV-DNA-positive rate, and the milk HBV-DNA content is proportional to serum viral load. Detection of the HBV-DNA content of breast milk in HBV-infeetive partu- rient women has great signfieance for interrupting mother to child transmission for HBV infection and providing a basis for guidanee for the choice of breast-feeding mothers.