摘要
目的观察山东省寿光市联合免疫阻断乙肝病毒(HBV)母婴传播效果,调查HBsAg阴性儿童中HBV隐匿性感染状况。方法2005—2017年在寿光市HBsAg阳性母亲及所生儿童中开展问卷调查并采集血清标本,用酶联免疫法检测HBV血清标志物,评价联合免疫阻断效果;用实时荧光定量法检测阻断后的儿童血清标本HBV DNA含量,计算HBsAg阴性儿童的OBI感染率。结果共调查儿童2096例,母婴阻断失败率2.96%,未检测出明显的OBI感染者;乙肝疫苗与乙肝免疫球蛋白(HBIG)联合免疫的阻断效果优于未联合免疫(χ~2=15.513,P<0.05),10μg乙肝疫苗优于5μg乙肝疫苗(χ~2=12.317,P<0.05);母亲HBeAg阴性、剖宫产、大龄产妇、母乳喂养的儿童感染率分别显著低于HBeAg阳性(χ~2=44.353)、自然分娩(χ~2=15.373)、低龄产妇(χ~2=16.309)和纯人工喂养(χ~2=16.689)的儿童(P<0.05);HBsAg阴性儿童血清样本中未测到HBV DNA。结论母亲HBeAg情况、分娩方式、分娩年龄、喂养方式,以及联合免疫阻断中乙肝疫苗剂量和儿童出生后是否接种过HBIG,是影响免疫阻断成败的相关因素。
Objective To observe the effect of blocking up mother to child transmission of HBV by combined immunization in Shouguang city,Shandong province,and investigate the occult HBV infection(OBI)in children with HBsAg negative.Methods The questionnaire was conducted in the mothers with HBsAg positive and their babies in Shouguang city from2005 to 2017,and the blood samples were collected for testing serum markers of HBV by ELISA to evaluate blocking effect of combined immunization.The content of HBV DNA in the serum samples of children was detected with real-time fluorescence quantitative method,and OBI infection rate of the children with HBsAg negative was calculated.Results Totally 2096 children were investigated with blocking failure rate of 2.96%,and no obvious OBI infection was detected.The blocking effect of hepatitis B vaccine combined with HBIG was better than that of non-combined immunization(χ~2=15.513,P<0.05).The hepatitis B vaccine of 10μg doses was better than that of 5μg doses(χ~2=12.317,P<0.05).The infection rate of the children was lower(P<0.05)in the mothers with HBeAg-negative,cesarean section,old puerperal and breast feeding than in the mothers with HBeAg-positive(χ~2=44.353),natural-born(χ~2=15.373),low-age puerpera(χ~2=16.309)and purely artificial feeding(χ~2=16.689).There was no HBV DNA detected in the serum samples of the children with HBsAg negative.Conclusions The relevant factors infecting the effect of blocking immunization by combined immunization were the infection with HBeAg in mothers,delivery way,delivery age,feeding way,doses of hepatitis B vaccine and whether injection of HBIG or not after born.
作者
崔佳
陈建霞
张月玲
王晓琼
刘中芹
刘召红
李建志
CUI Jia;CHEN Jian-xia;ZHANG Yue-ling;WANG Xiao-qiong;LIU Zhong-qin;LIU Zhao-hong;LI Jian-zhi(Shouguang Municipal Center for Disease Control and Prevention,Shouguang,Shandong 262700,China)
出处
《疾病预防控制通报》
2020年第1期60-63,共4页
Bulletin of Disease Control & Prevention(China)
基金
中国肝炎防治基金会—中国乙肝防控科研基金资助课题(YGFK20170009).
关键词
乙型肝炎病毒(HBV)
母婴阻断
联合免疫
隐匿性感染
Hepatitis B virus(HBV)
Mother-infant transmission,block
Combined immunization
Occult HBV infection(OBI)
作者简介
崔佳(1985-),女,主治医师,硕士,从事免疫预防工作,E-mail:cuijia0805@163.com
