PDF下载 ( 1999 KB)
Current status of hepatitis B virus infection among pregnant women in Shaanxi Province, China and risk factors for mother-to-infant transmission
-
摘要: 目的调查陕西省孕妇HBV感染率并筛选母婴传播高危人群。方法自2010年-2015年连续调查了陕西省18家医院13 451名孕妇HBV感染情况,对所有HBs Ag阳性孕妇所生婴儿进行联合免疫,采用单因素及多因素logistic回归分析母婴传播的高危因素。计量资料组间比较采用t检验或Mann-Whitney U检验。计数资料多组间比较采用χ2检验。结果陕西省孕妇HBsAg流行率为7. 07%,陕南地区高达9. 40%。HBV母婴传播率为5. 21%,单因素分析显示母亲HBsAg滴度、HBeAg滴度、HBeAg阳性及HBV DNA载量与婴儿HBV感染相关,多因素分析显示母亲HBV DNA载量是母婴传播的独立危险因素（相对危险度:1. 586,95%可信区间:1. 020～2. 465,P=0. 041）。发生母婴传播的HBV感染孕妇中,84. 62%为HBeAg阳性且HBV DNA> 106IU/ml;发生母婴传播的婴儿15. 38%来自于HBeAg阴性的HBV感染孕妇。HBeAg阳性且HBV DNA> 106IU/ml的孕妇中,婴儿发生母婴传播的相对危险度...Abstract: Objective To investigate the hepatitis B virus ( HBV) infection rate among pregnant women in Shaanxi Province, China and the high-risk population of mother-to-infant transmission ( MTIT) . Methods A survey was performed for 13 451 pregnant women in 18 hospitals in Shaanxi Province to investigate the status of HBV infection, and combined immunization was performed for the infants born to HBsAg-positive women. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for MTIT. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results The prevalence rate of HBsAg was 7. 07% among the pregnant women in Shaanxi Province, and the rate reached as high as 9. 40% in southern Shaanxi. The MTIT rate of HBV was 5. 21%. The univariate analysis showed that HBsAg titer, HBeAg titer, positive HBeAg, and HBV DNA load in mothers were associated with HBV infection in infants, and the multivariate analysis showed that HBV DNA load in mothers is an independent risk factor for MTIT ( relative risk = 1. 586, 95% confidence interval: 1. 020-2. 465, P = 0. 041) . Among the pregnant women with HBV infection and MTIT, 84. 62% had positive HBe Ag and an HBV DNA load of > 106 IU/ml; among the infants with MTIT, 15. 38% were the infants born to the HBe Ag-negative pregnant women. For the pregnant women with positive HBe Ag and HBV DNA > 106 IU/ml, the relative risk of MTIT in infants was 1. 210 ( 1. 129-1. 297) ; for the pregnant women with negative HBe Ag, HBV DNA > 2 × 103 IU/ml, and HBs Ag > 104 IU/ml, the relative risk of MTIT in infants was 26. 062 ( 2. 633-258. 024) . Conclusion There is a high HBV infection rate among pregnant women in Shaanxi Province. Pregnant women with positive HBeAg and a high HBV DNA load have a high risk of MTIT. Although the infants born to HBeAg-negative mothers have a low HBV infection rate, there is still a high risk of MTIT when the mother has an HBV DNA load of > 2 × 103 IU/ml and an HBsAg level of > 104 IU/ml.
-
[1] LIANG X, BI S, YANG W, et al. Epidemiological serosurvey of hepatitis B in China-declining HBV prevalence due to hepatitis B vaccination[J]. Vaccine, 2009, 27 (47) :6550-6557. [2] WANG HJ, DUAN ZP, ZHANG HH, et al. Research advances in the application of antiviral drugs during pregnancy for blocking mother-to-child transmission of hepatitis B virus[J]. J Clin Hepatol, 2018, 34 (10) :2208-2212. (in Chinese) 王慧娟, 段钟平, 张桓虎, 等.孕期服用抗病毒药物阻断HBV母婴传播的研究进展[J].临床肝胆病杂志, 2018, 34 (10) :2208-2212. [3] HAN GR, CAO MK, ZHAO W, et al. A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection[J]. J Hepatol, 2011, 55 (6) :1215-1221. [4] SUN KX, LI J, ZHU FC, et al. A predictive value of quantitative HBsAg for serum HBV DNA level among HBe Ag-positive pregnant women[J]. Vaccine, 2012, 30 (36) :5335-5340. [5] CHEN T, WANG J, FENG Y, et al. Dynamic changes of HBV markers and HBV DNA load in infants born to HBsAg (+) mothers:Can positivity of HBsAg or HBV DNA at birth be an indicator for HBV infection of infants?[J]. BMC Infect Dis, 2013, 13 (1) :524. [6] LIU J, ZHANG S, WANG Q, et al. Seroepidemiology of hepatitis B virus infection in 2 million men aged 21-49 years in rural China:A population-based, cross-sectional study[J].Lancet Infect Dis, 2016, 16 (1) :80-86. [7] DING Y, SHENG Q, MA L, et al. Chronic HBV infection among pregnant women and their infants in Shenyang, China[J]. Virol J, 2013, 10:17. [8] HUANG Y, LI L, SUN X, et al. Screening of pregnant women for hepatitis B virus surface antigen (HBs Ag) and subsequent management, Qiandongnan prefecture, Guizhou, China, 2010[J].Vaccine, 2013, 31 (Suppl 9) :j62-j65. [9] LIU JN. Awareness on the prevention and treatment of hepatitis B virus infection and mother-to-child transmission among the pregnant women of the first antenatal examination[J/CD].Chin J Exp Clin Infect Dis:Electronic Edition, 2019, 13 (1) :65-69. (in Chinese) 刘佳妮.初次产检孕妇对乙型肝炎病毒感染及母婴传播防治措施知晓度分析[J/CD].中华实验和临床感染病杂志:电子版, 2019, 13 (1) :65-69. [10] WEN WH, CHANG MH, ZHAO LL, et al. Mother-to-infant transmission of hepatitis B virus infection:Significance of maternal viral load and strategies for intervention[J]. J Hepatol, 2013, 59 (1) :24-30. [11] SONG YM, SUNG J, YANG S, et al. Factors associated with immunoprophylaxis failure against vertical transmission of hepatitis B virus[J]. Eur J Pediatr, 2007, 166 (8) :813-818. [12] GUO Z, SHI XH, FENG YL, et al. Risk factors of HBV intrauterine transmission among HBsAg-positive pregnant women[J]. J Viral Hepat, 2013, 20 (5) :317-321. [13] LI XM, SHI MF, YANG YB, et al. Effect of hepatitis B immunoglobulin on interruption of HBV intrauterine infection[J]. World J Gastroenterol, 2004, 10 (21) :3215-3217. [14] OGUNBUSI O, SMUTS H, ELEY B, et al. Fulminant hepatitis B virus (HBV) infection in an infant following mother-tochild transmission of an e-minus HBV mutant:Time to relook at HBV prophylaxis in South African infants[J]. S Afr Med J, 2018, 108 (5) :389-392. 期刊类型引用(10)
1. 杨晓曼. γ-谷氨酰转移酶/血小板在乙肝肝硬化失代偿期患者中的表达及临床意义. 河南医学研究. 2024(08): 1407-1410 . 
百度学术2. 刘爱华，符建，陈小红. 瞬时超声弹性成像联合GGT/PLT比值预测慢性乙型肝炎患者肝纤维化价值研究. 实用肝脏病杂志. 2023(05): 634-637 . 百度学术3. 肖少伟，杜亚哲. γ-谷氨酰转移酶/胆碱酯酶比值与γ-谷氨酰转移酶/血小板比值对慢性乙型肝炎患者肝纤维化程度的预测效能. 实用医技杂志. 2023(11): 812-815 . 百度学术4. 张玉婷，施欢，李虤，沈波. FibroTouch联合GGT/PLT比值对诊断乙型肝炎肝纤维化的临床价值. 江西医药. 2022(02): 206-209+216 . 百度学术5. 桑阿利. APRI、Fib-4和Fibroscan联合诊断慢性乙型肝炎肝纤维化程度的价值. 甘肃医药. 2022(10): 896-898 . 百度学术6. 王晔恺，于倩，姚燕珍，罗雯斌，洪开听，鲍舟君. 对数几率回归模型构建联合预测因子对慢性乙型肝炎患者早期肝硬化诊断的临床应用. 中国卫生检验杂志. 2021(01): 90-93+97 . 百度学术7. 陈兴，梁小桃. 肝瞬时弹性成像与天冬氨酸转氨酶/血小板指数在慢性乙型肝炎合并脂肪肝患者肝纤维化诊断中的应用价值. 中国当代医药. 2021(11): 60-62 . 百度学术8. 黄腊平，陈焰. 基于Fibroscan技术的柴胡疏肝散对非酒精性脂肪肝患者临床疗效分析. 清远职业技术学院学报. 2020(02): 35-38 . 百度学术9. 栗红江，何久胜，胡素玲，何福亮，田彦卿，刘震霞. 声辐射力脉冲成像技术、瞬时弹性成像技术及天冬氨酸氨基转移酶与血小板比率指数联合检测乙型肝炎肝纤维化程度临床效能. 临床军医杂志. 2020(09): 1090-1091+1094 . 百度学术10. 熊静，林登娜，翁伟镇，陈俊峰，曹会娟，张绍全，张静，高隽，林炳亮. FIB-4联合血清PCⅢ、ⅣC评估乙型肝炎病毒相关肝纤维化. 国际病毒学杂志. 2020(05): 403-406 . 百度学术其他类型引用(2)
-
百度学术
下载:
