Study On The Risk Factors And Genotype Of Vertical Transmission About HBV From HBsAg-positive Father To Fetal

Objective:To explore the risk factors of vertical transmission about HBV from HBsAg-positive father to fetal; analyze the relationship of HBV-DNA load and vertical transmission; study whether the genotype is consistent between father and fetal.Methods:Using HBsAg and HBV-DNA as screening indicators for pregnant women and their husbands from obstetric clinic from August 2009 to December 2010, totally 154 HBVM were negative or HBsAb was positive only and HBV-DNA was negative pregnant women, HBsAg-positive-husbands and their newborns were enrolled, all subjects provided informed consent for the participation in the study. HBV serological markers were detected by ELISA. HBV-DNA content was detected by fluorescent quantification-PCR (FQ-PCR) and genotypes of HBV were detected by type specific primers and high-resolution melting curve.Results:1. Of the 154 neonatal cord blood, 30(19.5%) were HBV-DNA positive. Univariate and multivariate regression analyses were performed to determine risk factors. Maternal HBsAb positive, paternal serum HBeAg-positive, serum HBV-DNA positive, semen HBV-DNA positive, the time of carrying HBV and neonatal sex were statistically significant in the univariate analysis (P<0.05). Multivariate analysis found that HBeAg-positive, serum HBV-DNA positive and semen HBV-DNA positive were still statistically significant (P<0.05).2. The paternal serum HBV-DNA load was positively correlated with the cord blood HBV-DNA load.3. The paternal serum HBV-DNA load was positively correlated with pregnant week, but they had a little correlation. 4. Of the 80 semen, 30 (37.5%) were HBV-DNA positive. There was a positive rank correlation between semen HBV-DNA and serum HBV-DNA load levels, the load levels of semen HBV-DNA was lower than that of serum HBV-DNA.5. The rate of HBsAg positivity for neonatal cord blood is 17.5% (27/154).6. No relationship was found between serum HBV-DNA load and pregnant week.7. Among the HBV-DNA load in the paternal serum, semen and cord blood, the paternal serum load was the highest, and the load in cord blood was lowest.8. The paternal serum HBV-DNA positive was no interaction with HBeAg-positive(P>0.05), on the contrary, paternal serum HBV-DNA positive was interaction with semen HBV-DNA positive (P<0.05).9. Both the history of pregnancy and neonatal outcome were not statistically significant between the case group and the control group (P>0.05).10. The HBV-DNA genotype was consistent with father and infant, genotype B is dominant, as well as a small amount of genotype C, genotype D, confection with genotype B and C.11. Genotype C had a higher serum HBV-DNA level compared with other genotypes.12. There was no significant difference about paternal HBV vertical transmission in the geographic distribution of Fuzhou.13. The negative conversion rate was 6.25% when positive infants were followed up to 6 months.Conclusion:1. The paternal serum HBV-DNA positive, semen HBV-DNA positive and HBeAg-positive are risk factors of paternal HBV vertical transmission.2. The HBV-DNA load in umbilical blood are positively correlated with the HBV-DNA load in serum and in semen of father. The load levels of father's serum HBV-DNA is the highest and the HBV-DNA load in cord blood is the lowest.3. The serum HBV-DNA positive and HBeAg-positive can not increase the risk, but the serum HBV-DNA positive and the semen HBV-DNA positive can increase the risk about HBV vertical transmission from father to fetal. 4. The study provides further evidence for paternal HBV vertical transmission in molecular level, the genotype is consistent. Genotype B is dominant,as well as a small amount of genotype C, confection with genotype B and C and genotype D.5. Genotype C has a higher serum HBV-DNA level compared with other genotypes.6. There is no geographical difference about paternal HBV vertical transmission in urban and suburb in Fuzhou.7. The research suggest that the key is to test qualitatively HBV-DNA in the serum and semen before pregnancy, positive men should receive effective anti-viral treatment and contraception, until the viral load is low level reproduction. The neonate should be injected 100U Hepatitis B immunoglobulin after the baby is born within 24 hours and the first month respectively.