Study On The Association Between HLA-DR Alleles And HBV Intrauterine Infection

OBJECTIVE: â‘ To study the association between HLA-DR3,DR7,DR13,DR53 and HBV intrauterine infection, to probe into the susceptibility tointrauterine infection of hepatitis B virus and to find it's predisposing genes andprotecting genes. â‘¡To study the risk factors of HBV intrauterine infection.METHODS: In Taiyuan infectious hospital, 187 pregnant women and 187newborns were collected between Jun. 2003and Nov. 2004,the epidemiologicalbase line data involving gestation and postpartum were also collected, maternalelbow vein blood and neonatal femoral vein blood (within 24 hours) beforeinjecting hepatitis B immunoglobulin(HBIG) were also collected at the sametime. Following studies were performed: HBsAg,HBeAg,HBV DNA inmaternal serum and HBsAg,HBV DNA in neonatal serum were determined byELISA and nested-PCR(nPCR);â‘¡HLA-DR3,DR7,DR13,DR53 weredetected by the technique of polymerase chain reaction-sequence specificprimers(PCR-SSP) in maternal and neonatal blood clot;â‘¢Risk factors of HBVintrauterine infection were analyzed by nested case control study and theinteraction among risk factors were also analyzed. All data were analyzed by thestatistical packages SPSS 11.0 for windows.RESULTS: 1. HBV intrauterine infection rate was 15.51%(29/187). HBVintrauterine infection rate was 5.90%(11/187) for HBsAg and 11.80%(22/187)for HBV DNA in neonatal blood serum. HBV intrauterine infection rate was27.78%(20/72) in HBsAg and HBeAg both positive mothers. 2. There was significant association between HLA-DR3 positive inpregnant women and HBV intrauterine infection (P=0.007, OR=4.71, 1.62-13.66).There was no association between HLA-DR7,DR13,DR53 positive in pregnantwomen and HBV intrauterine infection(P>0.05). 3. There was significant association between HLA-DR3 positive innewborns and HBV intrauterine infection (P=0.033,OR=3.91,1.18-12.94). Therewas no association between HLA-DR7,DR13,DR53 positive in newborns andHBV intrauterine infection(P>0.05). 4. There was significant association between HLA-DR3 concordance andHBV intrauterine infection(P=0.049,OR=5.96,1.14-31.15).There was noassociation between DR7,DR13,DR53 concordance and HBV intrauterineinfection(P>0.05). 5. Nested Case control study analysis showed that risk factors of HBVintrauterine infection were HLA-DR3(OR=4.65,1.44-15.05) positive and HBVDNA(OR=6.56,2.65-16.23) positive in pregnant women. There was nointeraction between the two factors. The exposure rate of other factors did notreveal the difference in two groups.CONCLUSIONS: 1. HBV intrauterine infection rate was 15.51% for HBsAgand/or HBV DNA in neonatal blood serum of HBsAg positive mothers. 2. HLA-DR3 carriers of pregnant women and their fetus havesusceptibility to HBV intrauterine infection. HLA-DR3 is the predisposing geneof HBV intrauterine infection. There was no association between HLA-DR7,DR13,DR53 and HBV intrauterine infection 3. Risk factors of HBV intrauterine infection were HLA-DR3 positive andHBV DNA positive in pregnant women. There was no interaction between thetwo factors.