定量HBsAg和定性HBeAg可以预测孕妇的宫内胎盘感染和脐带血

StephenW

Quantitative HBsAg and Qualitative HBeAg Predicts Intrauterine Placental Infection and Umbilical Blood Cord in Pregnant Women
Erry Gumilar Dachlan  1 , Cahyanti Nugraheni  1 , Alphania Rahniayu  2 , Muhammad Ilham Aldika Akbar  1   3
Affiliations
Affiliations

    1
    Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
    2
    Department of Pathology Anatomy, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
    3
    Department of Obstetrics and Gynecology, Universitas Airlangga Hospital, Surabaya, Indonesia.

    PMID: 33603802 PMCID: PMC7865194 DOI: 10.18502/jfrh.v14i2.4353

Abstract

Objective: To know the correlation between quantitative Hepatitis B surface Antigen (HbsAg) and maternal Hepatitis B Envelope Antigen (HbeAg) with hepatitis B intrauterine transmission via placental infection. Hepatitis B in pregnancy causes a mother to child transmission (MTCT) via transplacental route started with placental infection. HBV DNA viral load and HBeAg are the independent risk factors for MTCT, but it rarely available in developing country. Materials and methods: A cross-sectional study in 33 pregnant women with HbsAg positive in 4 referral hospital in East Java, Indonesia. Quantitative HBS Ag and HBeAg) status were determined serologically from a peripheral venous blood sample. Placental Hepatitis B infection was detected by immunohistochemistry of HBsAg from placental tissues. The intrauterine transmission was diagnosed by positive HBsAg in cord blood sampling after deliveries. Results: Serum quantitative HBsAg level has a good sensitivity and spesificity to predict placental infection (90% and 83%), with a cut off value of 3.14 Log10 IU/mL (AUC 0.87; 95% CI: 0.74-0.99). Quantitative HBsAg level also has a good sensitivity and spesificity to predict HBV transmission in umbilical blood cord (81.8% and 95.5%) with a cut off value of 3.62 log10 IU/ml (AUC: 0.925, 95% CI: 0.813-1; p = 0.000). Placental infection is significantly related with intrauterine transmission with OR 4.6 (95% CI 2.29-9.4; p = 0.002). Conclusion: The study reveals that maternal serum quantitative HBsAg level can be used as an alternative test to substitute HBeAg or HBV DNA as a marker to predict the placental infection and intrauterine transmission, especially in low-middle income countries.

Keywords: Hepatitis B; Hepatitis B Envelope Antigen (HbeAg); Intrauterine Transmission; Placental Infection.

Copyright © Tehran University of Medical Sciences.

StephenW

定量HBsAg和定性HBeAg可以预测孕妇的宫内胎盘感染和脐带血
Erry Gumilar Dachlan 1，Cahyanti Nugraheni 1，Alphania Rahniayu 2，Muhammad Ilham Aldika Akbar 1 3
隶属关系
隶属关系

    1个
    艾尔兰加大学医学院妇产科，印度尼西亚泗水Soetomo综合学术医院博士。
    2
    印度尼西亚泗水苏埃托莫综合学术医院Dr. Airlangga医学院病理解剖学系。
    3
    印度尼西亚泗水Universitas Airlangga医院妇产科。

    PMID：33603802 PMCID：PMC7865194 DOI：10.18502 / jfrh.v14i2.4353

抽象的

目的：了解定量乙型肝炎表面抗原（HbsAg）和孕妇乙型肝炎外壳抗原（HbeAg）与经由胎盘感染的乙型肝炎子宫内传播的相关性。怀孕期间的乙型肝炎通过胎盘感染开始的经胎盘途径引起母婴传播（MTCT）。 HBV DNA病毒载量和HBeAg是MTCT的独立危险因素，但在发展中国家很少见。材料和方法：对印度尼西亚东爪哇省4家转诊医院的33例HbsAg阳性孕妇进行横断面研究。从外周静脉血样本中通过血清学测定HBS Ag和HBeAg的定量状态。通过胎盘组织中HBsAg的免疫组织化学检测到胎盘乙型肝炎感染。分娩后脐带血样本中HBsAg阳性诊断为宫内传播。结果：血清定量HBsAg水平具有良好的敏感性和特异性，可预测胎盘感染（分别为90％和83％），截断值为3.14 Log10 IU / mL（AUC 0.87； 95％CI：0.74-0.99）。定量HBsAg水平还具有良好的敏感性和敏感性，可预测脐带血中HBV的传播（81.8％和95.5％），其截断值为3.62 log10 IU / ml（AUC：0.925，95％CI：0.813-1; p = 0.000）。胎盘感染与OR 4.6（95％CI 2.29-9.4； p = 0.002）与子宫内传播密切相关。结论：该研究表明，孕妇血清定量HBsAg水平可以替代HBeAg或HBV DNA作为预测胎盘感染和子宫内传播的标志物，特别是在中低收入国家。

关键字：乙型肝炎；乙型肝炎包膜抗原（HbeAg）；宫内传播；胎盘感染。

版权所有©德黑兰医科大学。

StephenW

http://mr.crossref.org/iPage?doi=10.18502%2Fjfrh.v14i2.4353