父亲精液HBV-D NA载量与HBV父婴垂直传播的相关性分析

摘要

Aim:To explore the impact of the load levels of paternal semen HBV-DNA on vertical transmission of HBV from HBsAg-positive father to infant.Methods:52 families of pregnant women with negative HBsAg and HBV-DNA and husbands with positive,serum HBsAg were selected.Clinical data and blood samples of the parents and their newborns、semen samples of the husbands were collected.Ser-um HBVM and the load levels of paternal blood and semen HBV-DNA were determined.In case-control study,based on the results of neonatal cord blood HBV-DNA detection,1 1 newborns with cord blood posi-tive HBV-DNA were selected as subiects,and 41 newborns with negative HBV-DNA as controls.Results:①The positive rate of neonatal cord blood HBV-DNA was found to be 21.2%(11/52),and that of se-men HBV-DNA was 26.9%(14/52).②The incidence of vertical transmission of HBV in infants with paternal positive semen HBV-DNA was found significantly higher than that in infants with paternal nega-tive semen HBV-DNA(P<0.01).③There was a positive rank correlation between semen and serum of HBV-DNA load levels,while the load levels of semen HBV-DNA was lower than that of serum HBV-DNA load levels.④The analysis of ROC curve showed that the prediction accuracy of semen HBV-DNA in the occurrence of vertical transmission were more accurate than that based on serum HBV-DNA load.Con-clusion:Paternal positive semen HBV-DNA is one of the risk fators for vertical transmission of HBV;re-ducing HBV-DNA load levels in paternal blood and semen before pregnancy may be a way to block father-fetal transmisson of HBV.%目的：探讨乙肝表面抗原（HBsAg）阳性父亲精液乙型肝炎病毒脱氧核糖核酸（HBV-DNA）载量对其新生儿发生HBV父婴垂直传播的影响，以期寻找阻断HBV父婴垂直传播的有效方法．方法：在知情同意的原则，以丈夫血清HBsAg阳性、孕母HBsAg及HBV-DNA均阴性的52个家庭作为研究对象，收集父母及其新生儿的相关资料及血液标本和父亲精液标本，检测血液乙肝病毒血清学标志物（HBVM）、HBV-DNA载量与精液HBV-DNA载量．依据其新生儿脐带血HBV-DNA检测结果作为分组标准，HBV-DNA检测为阳性11例为病例组，阴性41例为对照组，进行病例对照研究．结果：新生儿脐带血 HBV-DNA 阳性率为21.2％（11/52），52份精液 HBV-DNA 阳性率为26.9％（14/52）；精液HBV-DNA阳性父亲其新生儿发生HBV父婴垂直传播的危险性高于精液HBV-DNA阴性者（P＜0.01）；精液与其血清的HBV-DNA载量存在正相关关系，精液HBV-DNA载量低于其血清载量；ROC曲线分析显示，精液HBV-DNA载量在预测HBV垂直传播发生风险的效果优于血清HBV-DNA载量．结论：父亲精液HBV-DNA载量是HBV父婴垂直传播的危险因素；HBsAg阳性的男性在计划孕育前降低其血液及精液中HBV-DNA载量水平能降低HBV父婴垂直传播的风险．