| ObjectivesTo analyze the T lymphocyte subsets changes in hepatitis B virus (HBV)gravida carriers before and after injection high pricesd hepatitis B immunoglobulin (HBIG) in third trimester, and evaluation the hepatitis B immune globulin in clinical application.Materials and MethodsSelected 69 cases of Hepatitis B surface antigen (HBsAg)-positive gravida who had regular prenatal checkup on July 2009～April 2010 at the First Affiliated Hospital of Jinan University as subjects. At the same time, randomly selected 51 normal gravida and the spouse with HBsAg-negative at as control. All above sample had been informed consent. HBsAg-positive gravida would be divided into two groups,①32 hepatitis B carrier gravida injected HBIG 200IU at 28,32,36 gestational weeks respectively were as experimental group;②37 cases of hepatitis B carriers gravida had nerver injected the HBIG. On the bases of Hepatitis B e antigen (HBeAg), all gravida for hepatitis B carriers were divided into HBeAg-positive group and HBeAg-negative group which were 30 cases and 39 cases respectively. In this study, the HBV-DNA>103copies/ml was defined as HBV-DNA positive, HBV-DNA<103copies/ml was as HBV-DNA negative, all gravida of hepatitis B carriers is divided into 37 patients of HBV-DNA positive and HBV-DNA negative in 32 cases. All the HBsAg-positive gravida would be phlebotomized at 28 and 36 gestational weeks respectively, using Enzyme linked immunosorbent assay (ELISA) detection of HBV-Markers, fluorescence quantitative PCR (FQ-PCR) detection HBV-DNA, all collected gravida in the experiment at the same period would be tested T cell subsets as CD3+, CD3+CD4+,CD3+CD8+T lymphocyte percentage and CD4+/CD8+ratio and other relevant indicators by Flow cytometry (FCM).Results 1. The cell-immune in vivo cellular immunity of Hepatitis B virus carrier gravida is lower than normal pregnant women:The percentage of CD3+, CD4+and the ratio of CD4+/CD8+is lower than normal pregnant women, while the percentage of CD8+is higher than normal (P<0.05).2. In Hepatitis B virus carriers pregnant women, the CD4+, CD4+/CD8+ratio of HBV-DNA (+) pregnant women was higher than HBV-DNA (-) pregnant women, while the CD8+percentage was less than the HBV-DNA (-) pregnant women (P< 0.05).3. HBeAg (+) and (-) carriers of hepatitis B virus in pregnant women had no significant statistical difference in all T lymphocyte subsets (P> 0.05).4. The HBV-DNA copy number of pregnant women carrying Hepatitis B from 6.53±1.14 before injection of HBIG reduced to 5.12±1.14 after injection, the difference was significantly (P<0.05).5. Comparing with normal pregnant women, besides CD3+, the remaining various lymphocyte subsets of Hepatitis B virus carrier pregnant women vaccinated by HBIG after the injection of HBIG in pregnant women were statistically significant (P<0.05). While comparing with normal pregnant women, HBV-DNA (+) pregnant women after the injection of HBIG, in addition to CD4+, the residual value had no significant statistical difference (P> 0.05).6. Comparing normal pregnant women of 36 weeks or so and the 28th week, the CD4 +/CD8+ratio of 36 weeks or so is lower (P<0.05), while the CD3+, CD4+and CD8+values, the two had not statistically significant differences (P>0.05).Conclusion1. The cell-immune in vivo cellular immunity of Hepatitis B virus carrier gravida is lower than normal pregnant women.2. The Hepatitis B carriers in vivo cellular immunity is correlated with HBV-DNA copied number.3. The HBeAg status have no relationship with cellular immunity.4. HBIG injection during third trimester can reduce the maternal HBV-DNA replication in vivo volume. 5. During third trimester, to inject HBIG can improve gravida's cellular immunity, and this role for HBV-DNA positive pregnant women especially.6. The cellular immune regulatory function of 36 weeks pregnant is lower than about 28 weeks.
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