| ObjectiveTo study the relationship between the effects on immune balance of T helper cell 1,2(Th1/Th2) by interleukin-18(IL-18) level of pregnant women and hepatitis B virus infection,and to investigate the mechanism about the way of hepatitis B virus intrauterine infection.MethodsA total of 101 asymptomatic pregnant women who were HBV carriers (all tested positive for HBV serological markers HBsAg, HBeAg, anti-HBc) were recruited for the study. According to the tested results that the newborns are intrauterine infection or not the objects were randomly divided into two groups, study group (intrauterine infection group) 21 cases and control group (unintrauterine infection group)80 cases. The two groups women were both detected for interleukin-18, interferon-γ, interleukin-4 of serum prior to delivery by ELISA.Results1. There are 18 positive for HBV-DNA, 8 positive for HBsAg among 101 cord blood samples. A total 21 positve for HBV serologic markers, so the newborns intrauterine infection rate of 101 HBsAg positive mothers was 20.79 %( 21/101).2. The contrast of The serum mean IL-18 levels of two groups: The serum mean IL-18 levels of pregnant women in study group was 802.71±134.65pg/ml, significantly lower than 905.93±170.35 pg/ml of control (t=2.57, P<0.05).3. The contrast of The serum mean IFN-γ, IL-4 levels and The ratio of serum IFN-γ/IL-4 of two groups: The serum mean cytokine IFN-γlevels of pregnant women in study group was 468.47±86.93pg/ml, significantly lower than 547.42±107.32pg/ml of control (t=3.11,P<0.01). The serum mean cytokine IL-4 levels of pregnant women in study group was 133.96±51.18pg/ml, significantly higher than 108.42±28.83pg/ml of control (t=2.20,P<0.05). The ratio of serum IFN-γ/IL-4 levels of pregnant women in study group was 4.03±1.67, significantly higher than 5.48±1.99 of control (t=2.94,P<0.01).4. The correlation between The serum mean IL-18 and IFN-γ, IL-4, IFN-γ/IL-4 in two groups: The positive correlation existed between IL-18 and IFN-γboth in two groups, correlation coefficient were 0.747, 0.911(both P<0.01 of two groups); the negative correlation existed between IL-18 and IL-4 both in two groups, correlation coefficient were -0.640, -0.298 (both P<0.01 of two groups); The positive correlation existed between IL-18 and the ratio of IFN-γ/IL-4 both in two groups, correlation coefficient were 0.838, 0.634(both P<0.01 of two groups).Conclusions1. HBV intrauterine infection is related to the decrease of Th1 type cell activity and increase of Th2 type cell activity. The decrease of ratio of Th1/Th2 type cytokines in maternal serum and the imbalance of immune regulation of Th1/Th2 maybe the main mechanism of HBV intrauterine infection.2. HBV intrauterine infection is related to the decrease of IL-18. The effects of IL-18 on HBV intrauterine infection are through regulating the immune balance of Th1/Th2, especially through regulating the level of IFN-γ. the decrease of serum IL-18 maybe one of the risk factor of HBV intrauterine infection.
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