母婴传播风险和对乙肝病毒e抗原在妊娠妇女抗体水平。

StephenW

International Journal of Infectious Diseases

Available online 19 September 2014

In Press, Accepted Manuscript — Note to users

Maternal transmission risk and antibody levels against hepatitis B virus e antigen in pregnant women.

    Ling-Ling Lu  a, b,
    Bing-Xiang Chen b,
    Jiandong Wang c,
    Dongmei Wang a,
    Yue Ji a,
    Hong-Gan Yi a,
    Taoyang Chen a,
    Yue Zhang d,
    Eskild Petersen e,
    Qin Li b, ,
    Chunfeng Qu a, ,

    a State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
    b Qidong Liver Cancer Institute and Qidong People's Hospital, Qidong 226200, Jiangsu Province, China
    c Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
    d National Office for Cancer Prevention and Control, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
    e Department of Infectious Disease, Aarhus University Hospital, Aarhus, Denmark

    Received 10 April 2014, Revised 30 July 2014, Accepted 31 July 2014, Available online 19 September 2014



        DOI: 10.1016/j.ijid.2014.07.028
  
Summary
Background

The generation of antibodies (anti-HBe) against hepatitis B virus (HBV) e antigen (HBeAg) often coincides with clinical remission in chronic HBV patients. We aimed to examine the effect of maternal anti-HBe in protection against HBV mother-to-child transmission (MTCT).
Methods

A total of 140 chronic HBV-infected pregnant women participated in this study. Before delivery, maternal HBV serological markers and HBV viral load were determined and anti-HBe titers were semi-quantified. Neonatal hepatitis B surface antigen (HBsAg) and HBV-DNA status were determined from cord blood. The children were followed to age 1–3 years.
Results

The HBV-DNA positive rate in cord blood was 75.61% (31/41) in those who were born to mothers with serum HBV-DNA >106 IU/ml, which was significantly higher than in those who were born to mothers with HBV-DNA <106 IU/ml (3/99, 3.03%; p < 0.0001). However, 10 newborns from mothers with serum HBV-DNA >106 IU/ml had no detectable HBV-DNA in cord blood; anti-HBe was positive with a median titer of 10 (interquartile range 10–55). A total of 84 children who received hepatitis B immune globulin (HBIG) within 12 h after birth and who completed three doses of recombinant HBV vaccination were followed to age 1–3 years (up to May 2014). All 56 children who were born to mothers with serum HBV-DNA levels <106 IU/ml were HBsAg-negative. Five of the 22 children born to anti-HBe-negative mothers with serum HBV-DNA >106 IU/ml acquired an HBsAg-positive status. However, none of the six children who were born to anti-HBe-positive/weak-positive mothers with serum HBV-DNA >106 IU/ml acquired an HBsAg-positive status.
Conclusions

The presence of maternal anti-HBe is protective against HBV MTCT, independent of the maternal serum HBV viral load.
Keywords

    Hepatitis B virus;
    Mother-to-child transmission;
    Antibodies against HBeAg.

StephenW

传染病杂志

可在线2014年9月19日

在出版社，接受手稿 - 注意用户

母婴传播风险和对乙肝病毒e抗原在妊娠妇女抗体水平。

    玲玲露一，B，
    丙项琛B，
    建东王C，
    王冬梅A，
    乐记A，
    洪甘贻A，
    陶阳陈某，
    岳丈D，
    Eskild彼得森E，
    秦立B，，
    春风曲A，，

    分子肿瘤学，肿瘤医院，中国医学科学院，北京100021，中国的国家重点实验室
    b启东肝癌研究所启东市人民医院，启东226200，江苏省，中国
    Ç北京妇产医院，首都医科大学，北京，中国
    对于癌症预防与控制，肿瘤医院，中国医学科学院，北京，中国ð全国办公室
    传染病，奥胡斯大学医院，奥胡斯，丹麦的E系

    收到2014年4月10日，经修订的2014年7月30日，接受2014年7月31日，可在线2014年9月19日



        DOI：10.1016/ j.ijid.2014.07.028
  
摘要
背景

抗体（抗HBe）抗乙肝病毒（HBV），e抗原（HBeAg）的产生往往恰逢临床缓解慢性乙肝患者。我们的目的是检查产妇抗HBe的保护，防止乙肝病毒母婴传染给孩子（母婴传播）的影响。
方法

共有140慢性HBV感染的孕妇参与了这项研究。分娩，产妇乙肝病毒血清学标志和HBV病毒载量之前进行测定和抗HBe滴度半定量。新生儿乙肝表面抗原（HBsAg）和HBV-DNA的状态是从脐带血确定。孩子们跟着年龄1-3岁。
结果

在HBV-DNA阳性率脐带血为75.61％（31/41）在那些谁是母亲所生的血清HBV-DNA>106 IU/ mL，是比那些谁是天生的母亲与HBV-显著高DNA<106 IU/毫升（3/99，3.03％，P <0.0001）。不过，从与血清HBV-DNA的母亲的新生儿10>106 IU/ ml的没有检测到HBV-DNA的脐带血;抗HBe与10（四分位数间距10-55），中位滴度阳性。共谁收到乙肝免疫球蛋白（HBIG）12小时内出生后，谁84名儿童完成了三个剂量的重组乙肝疫苗随访年龄1-3年（最长2014年5月）。所有56名儿童谁是母亲所生的血清HBV-DNA水平<106 IU/ ml的HBsAg阴性。五天生抗HBe阴性母亲的血清HBV-DNA>106 IU/ ml时22儿童获得了HBsAg阳性的状态。然而，没有谁是天生的抗HBe阳性/弱阳性母亲的血清HBV-DNA>106 IU/ ml的六个孩子获得了HBsAg阳性的状态。
结论

产妇抗HBe的出现可预防乙肝病毒母婴传播的，独立于母体血清中乙肝病毒载量。
关键词

    乙型肝炎病毒;
    母亲传染给孩子;
    抗大三阳。