Research On The Correlation Between Viral Load Rheumatoid Factor And Placental Growth Factor In Pregnant Women With Hepatitis B

Background: China has high prevalence of hepatitis B,in which hepatitis B virus carrying rate is 10.0%-20.0%,and 40.0%-50.0% is transmitted from mother to child.About 2 million newborns are born with Hepatitis B virus because of mother-to-child transmission.At present,the clinical treatment of hepatitis B is mainly by interferon(IFN)or nucleotide drugs,which can interfere with the synthesis of viral DNA.However,HBV itself is an inflammatory pathological process,According to reports in the literature,rheumatoid factor,as an inflammatory factor caused by the infection of organisms with pathogens such as bacteria and viruses,has played a significant role in the development of patients with hepatitis B.Besides,the production of placental growth factor is closely correlated to vascular endothelial cells or inflammatory cells.On the other side,pregnant women in special physiological period,realizing the correlation between viral load of pregnant women with hepatitis B and rheumatoid factor is of great significance for the development of appropriate individualized mother-to-child blockade treatment programs.Objective: To Investigate the correlation between viral load of pregnant women with hepatitis B and rheumatoid factor and placental growth factor,and to provide some theoretical basis for maternal and infant blockage of pregnant women from the level of immunity.Method: 90 cases of pregnant women with hepatitis B were selected from April 2016 to December 2016,and 3 groups were divided according to HBV-DNA load.Group A HBV-DNA load was greater than 10E+06mIU/mL,namely the high viral load group.Group B HBV-DNA load was between 10E+02mIU/mL to 10E+06mIU/mL.Group C HBV-DNA load was less than 10E+02mIU/mL,which was low viral load group,with 30 cases per group.In the same period,30 pregnant women with normal physical delivery were admitted to the control group(group D).Group A was divided into 28 weeks of oral nucleotide drugs(Lamivudine),normal maternal and infant block treatment(A1 group),and no maternal and child blocking treatment(A2 group),15 cases in each group.No nucleotide drugs were used in group B during pregnancy.No nucleotide drugs were used during pregnancy in group C;Group D does not have any treatment.All other groups except A2 were drew blood in the morning of 23 th week and admission day on hospital,empty stomach,2 of 2.5 ml with informed consent(Group A2 only collect the blood sample after admission to hospital).Aliquot after serum centrifugation,put them in-80 ℃refrigerator.After one-time freeze thawing,quantitate HBV-DNA,check rheumatoid factor and placental growth factor.At the same time follow up and calculate positive rate of HBsAg and HBeAg on delivered babies born to women who have HBV in 24 hours and seven months of later,the correlation between viral load and rheumatoid factor and placental growth factor in pregnant women can provide a theoretical basis for the possibility of adding some immunotherapy the future and improving the blocking effect of mother and child.Results: There was no statistical significance between the four groups of inmaternal age,pregnancy times,birth and blood sampling(P >0.05).The levels of rheumatoid factor and placental growth factor in group A1,B and C were higher than that in group D(P<0.05).The level of pre-delivery rheumatoid factors and placental growth factor of A1 group was higher than that in group D(P<0.05),but there was no statistically significant difference between that and group B/group C(P>0.05).The levels of pre-delivery rheumatoid factors and placental growth factors of A2 were higher than those of B,C and D(P<0.05).At the same time,the level of rheumatoid factor and placental growth factor in A2 group was significantly higher than that in group A1(P<0.05).No lamivudine drugs were used in group B and C.There was no significant difference in the levels of rheumatoid factor and placental growth factor at 28 weeks of gestation and before delivery.(P<0.05).The positive rate of HBsAg and/or HBeAg at 24 hours and 7 months after birth were observed in all groups of maternal neonates.The positive rates of newborns in group A,B and C after delivery were higher than those in group D(P < 0.05)The positive rates of infants in group A1,A2 and B were higher than those in group C(P<0.05).The positive rate of infants with hepatitis B in group A2 was higher than that in group B(P<0.05).There was no significant difference between group A1 and group B(P>0.05).there was no significant difference between group B and group C(P>0.05),But the positive value was higher than of group C;The positive correlation between HBV-DNA quantification and rheumatoid factor and placental growth factor in pregnant women with hepatitis B(P<0.05).Conclusion:1.The level of HBV-DNA quantification is the most fundamental direct factor that determines the treatment of mother-to-child transmission.The higher the HBV-DNA quantification level in pregnant women,the worse the regulatory system and the higher intrauterine infection rate,indicating that rheumatoid factor and placental growth factor are related to the viral load.2.The positive correlation between HBV-DNA quantification and rheumatoid factor and placental growth factor.