Study On The Relationship Between HLA-DPB1 And Prevention Of Mother-to-child Transmission Of Hepatitis B

Objective:The purpose of this study was to investigate the different immune blocking effects（failure,no response,low response,medium response,high response）of newborns born to HBs Ag positive pregnant women in our hospital after active and passive combined immunization.Is there any difference between the expression level of HLA-DPB1 in umbilical vein and placental tissue and that of normal pregnant women?If so,what is the correlation between them?Method:HBs Ag positive pregnant women and their infants who delivered in our hospital from September 2019 to August 2021 and completed active and passive combined immunization and were able to undergo serological follow-up were selected as the case group,and normal pregnant women and their infants during the same period were selected as the control group.The experiment was approved by the Ethics Committee,and all subjects adopted the principle of voluntary enrollment and signed informed consent.Placental tissue and serum samples were collected,and the expression levels of HLA-DPB1 in placental tissue and umbilical venous blood were detected by immunohistochemical staining(Max Vision^TM method)and enzyme-linked immunosorbent assay（ELISA method）.The results were statistically analyzed by SPSS25.0 software package.Results:（1）None of the 76 subjects in the case group showed HBs Ag positive or HBV DNA positive during serological follow-up at 7-12 months of age,that is,the success rate of blocking after active and passive combined immunization was 100%（76/76）,and none of the infants born to HBs Ag positive pregnant women showed mother-to-child transmission.（2）Qualitative analysis was conducted by observing the positive expression rate of HLA-DPB1 in placental tissues:The positive expression rate of HLA-DPB1 in placental tissues of no response&low response groups（35.3%）,medium response group（44.4%）,high response group（73.9%）,control group（93.9%）.The difference was statistically significant after testing（P<0.05）.At the same time,pairwise multiple comparison was performed between the two groups:there were statistically significant differences between the no response&low-response groups and the control group（P<0.05/4=0.0125）,The difference between the middle response group and the control group was statistically significant（P<0.05/4=0.0125）.By measuring the average optical density（AOD）of HLA-DPB1 in the placental tissue,quantitative analysis of the AOD of HLA-DPB1 in the placental tissue of the four groups of subjects was performed:the value of HLA-DPB1 increased successively in the no response&low response group,medium response group,high response group and control group,and the difference was statistically significant through one-way ANOVA（P<0.05）.Pairwise multiple comparison between groups:there were statistically significant differences among all groups（P<0.05/4=0.0125）.（3）HLA-DPB1 was expressed in umbilical venous blood samples of all groups,but the difference was not statistically significant（P>0.05）.（4）According to the level of serum HBs Ab at follow-up,the case group was divided into no response&low response group,medium response group and high response group.The basic information of the subjects in each group was statistically analyzed,and the results were as follows:The incidence of non-response and low response was 0.373 times higher in the high education group than in the low education group（OR=0.373,P=0.036）.The incidence of no response&low response was 0.154 times higher in the low HBe Ag group than in the high HBe Ag group（OR=0.154,P=0.004）.Conclusion:（1）The expression level of HLA-DPB1 affects the blocking effect of mother-to-child transmission of hepatitis B.These results suggest that HLA-DPB1expression may be a protective factor in the immune response of active and passive combined immune response and HLA-DPB1 may be an insusceptible gene of hepatitis B virus infection.（2）High educational level and low level of HBe Ag in pregnant women were independent protective factors for the effect of active and passive combined immune response.（3）The effect of the current hepatitis B vaccine combined immunoglobulin（active and passive combined immunization）blocking scheme is very significant.The low follow-up rate in some populations leads to an increased possibility of adverse outcomes.