Study On The Risk Factors Of Vertical Transmission Of HBV From HBsAg-positive Father To Infant

Objective:To study the risk factors of vertical transmission of HBV from HBsAg-positive father to infant by case-control study in order to provide scientific evidence for paternal-fetal transmission of HBV prevention.Methods:Using HBsAg and HBV-DNA as screening indicators for pregnant women and their husbands from obstetric clinic from September 2007 to December 2008,161 HBVM were negative or only HBsAb was positive and HBV-DNA were negative pregnant women,HBsAg was positive husbands and their newborns were selected.A self-designed questionnaire was conducted,information of pregnant women,their husbands and their newborns were collected;blood samples of pregnant women,their husbands,their newborns and semen samples of husbands were collected for related indicators detection.In case-control study,according to neonatal cord blood HBV-DNA detection,newborns with cord blood HBV-DNA positive were selected as cases,others as controls.The risk factors of vertical transmission of HBV from HBsAg-positive father to infant were analyzed by univariate and multivariate logistic regression analysis.Results:①The study showed that:The positive rate of neonatal cord blood HBV-DNA rate was 22.4%.Univariate analysis showed:paternal HBeAg positive, serum HBV-DNA positive,semen HBV-DNA positive,first class family history and the time of HBV infection were statistically significant(P<0.05)(OR=2.7,5.2,11.9, 8.3 and 1.4).Using multiple logistic regression analysis to eliminate the effect of confounding factors,paternal serum HBV-DNA positive and first class family history were still statistically significant(P<0.05).The rata of vertical transmission of HBV from HBsAg-positive father to infant in the paternal serum HBV-DNA≥1.0×l07copies/ml group was significantly higher than HBV-DNA<1.0×l07copies/ml group.Furthermore,there was dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive in newbrons(trend x~2 =64.117,P=0.000).②The positive rate of semen HBV-DNA was 33,3%(9/30);There is a positive rank correlation between semen HBV-DNA positive and vertical transmission of HBV from HBsAg-positive father to infant;the load levels of semen HBV-DNA is lower than serum HBV-DNA load levels.③There was no significant difference at neonatal delivery mode,gestational weeks,birth weight,length,gender,1 minute Apgar score, pathological jaundice of newborns,abnormality,death between Case group and control group(p > 0.05).Conclusion:①Paternal serum HBV-DNA positive and first class family history were the risk factors of vertical transmission of HBV from HBsAg-positive father to infant.And serum HBV-DNA≥1.0×107 compies/ml was the high risk factors of vertical transmission of HBV from HBsAg-positive father to infant.There was dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive in newbrons.②Part of semen of HBsAg-positive father is infective.The load levels of semen HBV-DNA is lower than the load levels of serum HBV-DNA load levels.There is a positive rank correlation between semen HBV-DNA positive and vertical transmission of HBV from HBsAg-positive father to infant.③There is no correlation between pregnancy outcome and vertical transmission of HBV from HBsAg-positive father to infant.④The results suggest that HBsAg-positive father should receive effective anti-viral treatment before the planned pregnancy,to reduce HBV - DNA load levels of their blood and semen would be the key to blocking vertical transmission of HBV from HBsAg-positive father to infant.