Study On The Risk Factors And Genotype Of Vertical Transmission Of HBV From Couple To Infant

ObjectiveTo explore the risk factors and genotype of vertical transmission of HBVfrom HBsAg or HBV-DNA positive couple to infant,providing effective andscientific HBV prevention measures.Methods46families who had antenatal examination, pregnancy check-ups and gavebirth at Fujian Provincal Maternal and Child Health Hospital during August2010to November2011were chosen as research object. The information ofpregnant women,their husbands and their newborns were collected.Thosecouples'blood,hushands'sperm during pregnancy follow-up and justbefore delivery as well as their infants' umbilical cord blood werecollected for related indicators detection.HBV serological markers wereanalysed by ELISA. HBV-DNA load and genotypes of HBV were analysed byfluorescent quantification-PCR (FQ-PCR) and type specific primers andhigh-resolution melting curve respectively.Results1.The positive rate of neonatal cord blood HBV-DNA was45.7%(21/46).Univariate analysis showed that couple serum HBsAg-positiveHBVM different mode, couple serum HBeAg-positive, couple serum HBV-DNApositive,and couple serum HBV-DNA load were statistically significant(P<0.05). Using multivariate analysis to eliminate the effect ofconfounding factors, maternal serum HBV-DNA positive and paternal serumHBV-DNA load were still statistically significant(P<0.05).Maternal serumHBV-DNA positive and paternal serum HBV-DNA load did not show anyinteraction.There were dose-response relationship between couple serumHBV-DNA load level and neonatal cord blood HBV-DNA load level. The analysis of ROC curve showed that maternal serum HBV-DNA load level (1000copies/ml) and paternal serum HBV-DNA load level (10000copies/ml) werebetter demarcation point to forecast the occurrence of verticaltransmission of HBV from HBsAg or HBV-DNA positive couple toinfant,because there were better sensitivity and specificity duringforecast.2.The maternal serum HBV-DNA load was positively correlated with thecord blood HBV-DNA load and the load level of maternal serum HBV-DNA washigher than cord blood HBV-DNA.3.The paternal serum HBV-DNA load was positively correlated with thecord blood HBV-DNA load and the load level of paternal serum HBV-DNA washigher than cord blood HBV-DNA.4.The paternal serum HBV-DNA load was positively correlated with semenHBV-DNA load and the load level of paternal serum HBV-DNA was higher thansemen HBV-DNA.5. The positive rate of semen HBV-DNA was22.6%. while the positive rateof maternal serum HBV-DNA and paternal serum HBV-DNA were52.2%(24/46)and69.6%(32/46)respectively. All three were no relationships withgestational age.6.The positive rate of cord blood HBsAg was34.8%(16/46) while thepositive rate of cord blood HBeAg was23.9%(11/46).7.The history of pregnancy,couple's first class family history and HBVcarried time, liver function and neonatal outcome were no significantdifference between the case group and the control group (P>0.05).8.23families total69portions serum samples were analysed genotype,the HBV genotype was dominant with B genotype, as well as a small amountof C genotype.9families were both couple and infant with B genotype.10families from paternal transmission included7families with Bgenotype,the else with C genotype.While4families from maternal transmission were B genotype.9.Genotype C of paternal serum HBV-DNA load was higher than genotype B.10. The negative conversion rate was15%(3/20) when HBV-DNA positiveinfants were followed up to7months.Conclusion1.Maternal serum HBV-DNA positive and paternal serum HBV-DNA load wererisk factors of vertical transmission of HBV from HBsAg or HBV-DNApositive couple to infant.2. The couple serum HBV-DNA load was positively correlated with the cordblood HBV-DNA load and the load levels of couple serum HBV-DNA were higherthan cord blood HBV-DNA. The paternal serum HBV-DNA load was positivelycorrelated with semen HBV-DNA load and the load level of paternal serumHBV-DNA was higher than semen HBV-DNA.3. Maternal serum HBV-DNA positive and paternal serum HBV-DNA load didnot increase the risk of vertical transmission of HBV from HBsAg or HBV-DNApositive couple to infant.4.This study provided further evidence of vertical transmission of HBVnot only by maternal transmission,but also by paternal transmission atmolecular level. The genotype mostly were B genotype, as well as a smallamount of C genotype.5.Genotype C of paternal serum HBV-DNA load was higher than genotype B.