HIV暴露婴儿HBV感染状况研究

目的 调查HIV阳性母亲所生婴儿(HIV暴露婴儿)的HBV感染状况,间接评估该人群HBV疫苗免疫效果.方法 从我国HIV阳性母亲所生婴儿干血斑样本库中随机抽取106份HIV感染婴儿样本(HIV阳性组)、107份HIV未感染婴儿样本(HIV阴性组),采集100份HIV阴性母亲所生婴儿的全血制备成干血斑样本(HIV未暴露组).所有样本用Qiagen试剂盒进行HBV DNA检测.用Fisher精确概率法比较样本组间HBV感染率差异;HIV暴露组和我国1～4岁儿童HBV感染率的比较通过直接计算Poisson分布的累计概率进行假设检验.结果 HIV阳性组中HBV感染率是2.83％,阴性组和未暴露组中均未检测到HBV感染,三组间感染率差异无统计学意义.HIV暴露婴儿校正后HBV感染率为0.18％,不高于我国l～4岁儿童HBV感染率0.32％.结论 我国HIV暴露婴儿HBV感染率较低,HBV免疫策略实施效果良好,未受到HIV暴露的影响.

HBV infections among HIV-exposed infants in China

Objective To investigate the status of hepatitis B virus (HBV) infections in infants born to HIV-positive mothers in China,and to evaluate HBV vaccination efficacy in this population indirectly.Methods Dried blood spot samples (DBSs) from 106 HIV-infected infants,namely the HIV positive group,and 107 DBSs from HIV uninfected infants born to HIV positive mothers,namely the HIV negative group,were chosen randomly.Whole blood samples from 100 infants born to HIV negative mothers were used to prepare DBSs of HIV-unexposed group.All samples was tested for HBV DNA by a Qiagen kit.Fisher's exact test was used to evaluate differences of HBV infection rates between groups.HBV prevalence of HIV exposed infants and 1～4 years old children were compared by calculating cumulative poisson distribution probability.Results The rate of HBV infections in HIV positive group was 2.83％.No HBV infection in both HIV-negative group and unexposed group were found.HBV infection rates were in the order of HIV positive group ＞ HIV negative group =unexposed group,but differences between the three groups were not statistically significant.Our study showed that adjusted HBV prevalence in HIV exposed infants was 0.18％,which was not higher than that of HBsAg prevalence rate of 0.32％ among general children aged 1～4 years old.Conclusions HBV prevalence is low in HIV exposed infants,And the effect of present HBV immunization strategy is good in this population,and not affected by HIV exposure.