| Hepatitis B virus infection is one of the public health problem which endangers the human health. HBV intrauterine infection is one of the most important routes of HBV infection. Many studies suggested that mother with positive HBeAg and high loads of HBV DNA were main matters that caused HBV intrauterine infection. While recent clinical studies have discovered that, it was easy to find HBV intrauterine infection when the HBeAg was negative. In the HBV, the mutation G→A in the 1896 point of the pre-C region may cause the transmission of patients whose HBeAg were negative. So,that clues to the possibility that the precore region nucleartide 1896 mutation may cause the transmission of patients, besides the positive of HBeAg and high loads of HBV DNA. Placental infection is the high risk factor of HBV intrauterine infection, through detecting the T-lymphocyte,hofbauer cells and the level of IL-2 to reflect the immune of cells which are infected by HBV. The task was to study the relativity between the mutation G→A in the 1896 point of the pre-C region and HBV intrauterine infection, and then to discuss the mechanism how the HBV which have the mutation in the 1896 point of the pre-C region can transmit by the route of placenta.Section 1 Study on the relativity between the mutation in the 1896 point of the pre-C region and HBV intrauterine infectionObjective:To investigate the relativity between the mutation in the 1896 point of the pre-C region and HBV intrauterine infection.Methods:To make the pregnant women who were HBsAg carriers and their infants into one pair, and there were 294 pairs, then made them into two groups(group one:149 pairs with the mutation in the 1896 point of the pre-C region and group two:145 pairs without the mutation), to detect the serological markers of HBV and the loads of HBV-DNA in the acid blood of the pregnants and the peripheral venous blood of their infants through immunofluorescence double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) and amplification of viral nuckleic (real-time quantitative PCR).Results:The mean of the loads of HBV-DNA in the acid blood in these two groups was 6.781±0.894 and 2.706±0.789 respectitively, it had statistically significant difference (t= 10.7991, p<0.01). In group 1, the pregnant women with negativec HBeAg and positive HBeAg had a infection rate of 15.71% (11/70), and 16.46% (13/79) respectitively, with no statistically significant difference (X2= 0.02579, p>0.05). There were 23 and 11 cases of positive HBsAg and\or positive HBV DNA in the infants of these two groups. Group 1 had a higher infection rate of 15.14% (23/149) which was caused by HBV intrauterine infection compared with Group 2 which had the rate of 7.59% (11/145), the difference was statistically signf icant (X2= 4.4279, p<0.05)Conclusions:(1)In the pregnant women who were chronic HBV carriers,the cases who had the mutation in the 1896 point of the pre-C region had a higher level of HBV DNA compared with the ones without the mutation. (2) The low expression of HBeAg caused by the mutation of HBV didn't decrease the rate of HBV infection in uterus. (3)The mutation G→A in the region 1896 of the pre-C increased the rate of HBV intrauterine infection.Section 2 Study on the placental cellular immunity of pregnant women who had the mutation in the 1896 point of the pre-C regionObjective:To discuss the mechanism how the HBV which have the mutation in the 1896 point of the pre-C region can be transmitted by the route of placentaMethods:To make the subjects:pregnant women who were HBV carriers into two groups:Group one:32 cases with the mutation in Pre-C, Group two:29 cases without the mutation. Collected the placental tissue samples, detected the immune cells and cytokine in the placental tissue by the immunohistochemistry.Results:The mean counts of CD3 positive T lymphocytes and CD68 positive Hofbauer cells in these two groups were 39.2±4.185 and 9.6±2.503,22.7±4.5227 and 9.5±2.713,respectively. The result of variance analysis suggested:the two indicators in the two groups had a statistically significant difference (t= 19.1958, p<0.01), (t=8.31889, p<0.01). The positive rate of IL2 in these two groups were 78.12% and 13.79%. In group 1, the counts of CD3 positive T lymphocytes and CD68 positive Hofbauer cells significantly increased,the same as the expression of IL2Conclusions:When the gene of HBV had the mutation in the 1896 point of the pre-C region, the rate of placental infected by HBV would increase, and so do enhance in cellular immunity mediated by T lymphocytes and Hofbauer cells... |
PDF Full Text Request