Seroprevalence of hepatitis B infection during pregnancy and risk of perinatal transmission
Seroprevalence of hepatitis B infection during pregnancy and risk of perinatal transmission
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DOI：
10.1007/s12664-011-0083-y
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发表时间：
2011-03-01
影响因子：
2
通讯作者：
Verma, Manju
中科院分区：
文献类型：
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作者：
Dwivedi, Manisha;Misra, Prakash;Verma, Manju
目的了解孕妇乙型肝炎表面抗原（HBsAg）的血清阳性率及围生期乙型肝炎病毒（HBV）传播的可能危险因素。方法对4000例孕妇进行病史、体格检查和血清HBsAg检测。对于HBsAg阳性的妇女，进行肝功能检查和乙型肝炎e抗原（HBeAg）检查。采用聚合酶链反应（PCR）检测HBV DNA。结果在研究的4000名女性中，37名（0.9%）检测出HBsAg阳性。在这37名妇女中，6名（16%）表现为急性肝炎，31名（84%）无症状。HBsAg阳性率最高的年龄组为2125岁（1.15%），其次为26-30岁（0.86%）。风险因素评估显示29/37（78.4%）女性有纹身史。37例妇女中有21例（56.8%）HBeAg阳性。在16例HBeAg阴性妇女中，5例HBV DNA和抗hbe抗体阳性，6例只有抗hbe抗体，5例既没有HBV DNA也没有抗hbe抗体。在HBeAg和HBV DNA阳性母亲所生的婴儿中，65%（13/20）出现垂直传播。相比之下，HBeAg和HBV DNA均阴性的母亲所生的婴儿只有9.1%（1/11）。在经阴道分娩的25名婴儿中，15名（60%）发生垂直传播。择期剖宫产的四名婴儿均无垂直传播的迹象。结论产前妇女血清HBsAg阳性率为0.9%。乙型肝炎病毒抗原和乙型肝炎病毒DNA阳性与较高的垂直传播机会相关
Objectives To investigate the seroprevalence of hepatitis B surface antigen (HBsAg) in pregnant women and possible risk factors for perinatal hepatitis B virus (HBV) transmission.Methods Four thousand pregnant women were evaluated using history, examination, and test for serum HBsAg using commercial enzyme immunoassay kits. For HBsAg positive women, liver function tests and a test for hepatitis B e antigen (HBeAg) was done. HBV DNA analysis was done by polymerase chain reaction (PCR).Results Of 4,000 women studied, 37 (0.9%) tested positive for HBsAg. Of these 37 women, 6 (16%) presented with acute hepatitis and 31 (84%) were asymptomatic. The highest HBsAg positivity rate was seen in the age group of 2125 years (1.15%) followed by 26-30 years (0.86%). Assessment of risk factors revealed history of tattooing in 29/37 (78.4%) women. HBeAg was positive in 21 of 37 (56.8%) women. Of the 16 HBeAg negative women, 5 were positive for HBV DNA and anti-HBe antibody, 6 had only anti-HBe antibody and 5 had neither HBV DNA nor anti-HBe. Vertical transmission was seen in 65% (13/20) of babies born to mothers who were positive for HBeAg and HBV DNA. In contrast, it was only 9.1% (1/11) for babies born to mothers who were negative for both HBeAg and HBV DNA. Of the 25 babies delivered vaginally, 15 (60%) developed vertical transmission. None of the four babies delivered by elective cesarean section had evidence of vertical transmission.Conclusions Seroprevalence of HBsAg in antenatal women was found to be 0.9%. HBe-antigen and HBV DNA positivity was associated with a higher chance of vertical transmission