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目的:通过调查孕产妇慢性感染的乙型肝炎病毒表面抗原基因特征,分析与HBV母婴传播相关的病毒因素。方法:收集在江西省妇幼保健院待产的518份孕产妇血清。ELISA法筛查HBV感染者,抽提血清中HBV DNA,采用PCR扩增HBV S基因并测序,利用Genotyping软件对PCR产物序列进行HBV分型。应用Clustal X和Bioedit软件将不同感染者的HBV S基因核苷酸与参考序列进行多重比对,分析HBV S基因的突变和HBV亚型。结果:518例孕产妇中17例HBV阳性感染,13例标本PCR反应阳性,PCR产物测序结果显示均为HBV S基因,10例感染B基因型HBV,属于adw亚型;3例感染C基因型HBV,属于adr亚型;序列比对分析结果显示,5例标本在“a”抗原决定簇序列上出现三种形式变异,2例为A530G→T126A,1例为A541C→Q129H,2例为G587A→G145;1例Pres2区出现密码子缺失突变。结论:江西地区孕产妇主要感染B和C基因型HBV;在表面抗原“a”抗原决定簇上有点突变出现,可能是母婴传播,逃避疫苗免疫保护的一种机制。
Objective: To investigate the viral factors associated with mother-to-child transmission of HBV by investigating the gene signature of hepatitis B virus surface antigen in chronic maternal infection. Methods: 518 maternal serums to be produced in MCHMC of Jiangxi Province were collected. HBV was screened by ELISA, HBV DNA in serum was extracted, and HBV S gene was amplified by PCR and sequenced. Genotyping software was used to genotype HBV in PCR products. Clustal X and Bioedit software were used to multiplex HBV S gene nucleotide of different infected persons with reference sequence to analyze HBV S gene mutation and HBV subtype. Results: Among 518 pregnant women, 17 cases were positive for HBV infection, 13 cases were positive for PCR reaction, all of them were HBV S gene, 10 cases were infected with HBV genotype B and adw subtype, 3 cases were infected with genotype C HBV, belong to the adr subtype. The results of sequence alignment showed that there were three forms of variation on the “a” antigenic determinant of the 5 specimens, 2 cases of A530G → T126A, 1 case of A541C → Q129H, 2 cases G587A → G145; 1 case of Pres2 region codon deletion mutation. CONCLUSIONS: Infection of pregnant women and pregnant women in Jiangxi Province with B and C genotypes HBV; some mutations in the surface antigen “a” antigenic determinant may be a mechanism of mother-to-child transmission and evade vaccine immune protection.