| Objective The infection of HBV is a worldwide problem of public health. China is one of the region with high infection rate of HBV , one of the reasons that China has so many HBV carriers is intrauterine transmission , but the machanism of HBV intrautcrine transmission is not clear yet . It is considered that homogenous( by damage of placental vessels) and cellular (through placental cellular transfer of HBV) are two ways of HBV intrauterine transmission . But the two ways can not be used to explain the phenomenon that intrauterine infection of HBV occurred without the two ways , even the HBV DNA positive is the only expression of intrauterine infection of HBV . The question is .whether or not IlBsAg positive mother' s PBMC can infect the newborn by placental , whether or not the newborn' s PBMC is the replication site of HBV out of liver. It is an important problem associated with the mechanism of HBV intrauterine transmission . To make the problem clear , we must know clearly about the replication of HBV . Few study was done in the replication of PBMC HBV , Tangshixing' study was only about the detection of HBV DNA in PBMC and it' s relation with HBV DNA in sera . There were some more studies about the replication of HBV DNA , but conclusions were not same , Stoll-Becker' s study showed HBV can replicate in PBMC , produce infective virus and cause disorder immunological function, which was related to the continuous existence of HBV , while Kock' s study showed that the HBV DNA detected in PBMC is the adsorbed HBV . HBV cccDNA is the templat of HBV , whether we can find it in PBMCis the key to determine whether PBMC is the replication site out of liver . Dongjie' s report concerned the detection of cccDNA using sPCR . Though the detection method was created , the cases was not enough and the study was conducted in vitro , which maked it difficult to draw an objective conclusion in population view. To make clear the mechanism of intrauterine infection , it is necessary to study the PBMC HBV in the molecule level. This paper performed studying as follows:(1) the infection status of HBV in HBsAg positive mothers and their newborns ; (2) the status of 11BV infection and replication in PBMC and it' s role with intrauterine infection of HBV ; (3) risk factors of HBV intrauterine infection and HBV replication in PBMC .Methods 151 pregnant women were collected as study cohort between June 2001 and December 2002 in Taiyuan infectious hospital. Following up until they generated. Blood specimens from pregnant women and blood specimens from infants within 24 hours are collected . PBMC were separated from blood. HBsAg and HBeAg in sera were determined by ELISA ; HBV DNA were determined by nested PCR; PBMC HBV DNA were determined by selected PCR ; Risk factors of HBV intrauterine infection and HBV replication status in PBMC were analyzed by nested case control study using the computer packages VFP and SPSS .Results 1. HBV intrauterine infection rate was 37. 75% . HBV intrauterine infection rate was 3.31% for HBsAg in sera , 19.21% for HBV DNA and 23. 84% for PBMC HBV DNA in newborns .2. 15(9.93%) out of 151 HBsAg positive pregnant women had HBV cccDNA in their PBMC, 7(4.58%) out of 153 newborns had HBV cccDNA in their PBMC, 5(71. 43%)out of 7 newborns' mother had HBV cccDNA. 55(36.42%) out of 151 HBsAg positive pregnant women had HBV rcDNA in their PBMC, 35(22.88%) out of 153 newborns had HBV rcDNA in their PBMC.There are 57 pregnant women (37. 75%) and 36 newborns(39. 39%) whose IIBV cccDNA or HBV rcDNA were positivees.3. Nested Case control study analysis showed that risk factors of HBV intrauterine infection were PBMC HBV rcDNA ( OR=2.47, 1.22-4.98) positive and HBV DNA (OR=1. 63, 0. 82-3. 26) positive in pregnant women.4. Case control study demonstrated that risk factor of HBV replication in pregnant women' s PBMC was HBeAg positive( OR=3. 67, 1. 19-11.35 ) in themselves; risk factors of HBV replication in newborns' PBMC were PBMC HBV cccDNA positive(OR=38. 02, 4. 76-303. 43) in their moth...
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