现代中西医结合杂志2025，Vol.34Issue(8)：1057-1062,6.DOI:10.3969/j.issn.1008-8849.2025.08.006
HBeAg阳性高病毒载量慢性乙型肝炎孕妇分娩婴儿联合免疫后抗-HBs应答水平影响因素研究
Influence factors for anti-HBs response in infants of HBeAg-positive with high viral load pregnant women with chronic hepatitis B after combined immunization
摘要
Abstract
Objective It is to investigate the influence factors for the level of serum anti-HBs in infants born from HBeAg-positive with high viral load pregnant women with chronic hepatitis B after combined immunization.Methods This study enrolled200 chronic hepatitis B pregnant women with high viral load(HBVDNA>2.0×105 IU/mL)and their neo-nates,who were admitted to Shijiazhuang Fifth Hospital and Shijiazhuang Maternal&Child Healthcare Hospital from Janu-ary 1,2017 to September 30,2022.The infants were divided into low-response group(anti-HBs≤100 IU/L)and high-response group(anti-HBs>100 IU/L)according to their serum anti-HBs levels at7-12 months of age.The baseline char-acteristics(including general data,antiviral medication use,liver function,levels of serum HBV markers and HBV DNA at 24 weeks of gestation)and the indicators related to hepatitis B virus infection(serum HBV markers and HBV DNA levels)and liver function at delivery of the mothers were compared between the two groups.Additionally,the age,sex,delivery mode,birth weight,serum HBV markers and HBeAg positive rate of the infants at delivery,and their serum HBeAg level and HBeAg conversion rate in 7-12 months after birth were also compared,the factors that influence the Anti-HBs level in infants were analyzed by Multifactorial Logistic Regression Analysis.Results There were no statistically significant differ-ences in age,antiviral treatment duration,times of pregnancy and delivery,adverse pregnancy history,family history of hepatitis B at baseline,HBsAg,HBeAg,HBV DNA levels,proportion of HBV DNA>8 log10 IU/mL,ALT or AST lev-els,and ALT or AST elevation rates after pregnancy for 24 weeks and treatments with tenofovir disoproxil fumarate or tibivu-dine during pregnancy of the mothers between the two groups(all P>0.05),while there were no significant differences in the levels of serum HBsAg,HBeAg,HBV DNA,ALT,AST,and ALT or AST elevation rates at delivery between the two groups(all P>0.05).There were no statistically significant differences in the gestational age,gender,deliver mode,birth weight,levels of serum HBsAg and anti-HBs of the infants between the two groups(all P>0.05);the level of serum HBeAg and HBeAg positive rate of the infants of the low-response group at birth were significantly higher than those of the high-responser group(all P<0.05);there were no significant differences in the HBeAg level and HBeAg conversion rate at 7-12 months after birth between the two groups(all P>0.05).The HBeAg level and HBeAg positive rate of infants at birth were the independent factors that influenced anti-HBs level(all P<0.05).Conclusion Post-combined-immunization anti-HBs levels in the infants born from HBeAg-positive with high viral load pregnant women with chronic hepatitis B are closely associated with neonatal HBeAg positivity and quantitative levels.Qualitative and quantitative detection of neonatal HBeAg is helpful for predicting the anti-HBs responses,so as to early identify those infants with low responses and give supplementary immunization.关键词
慢性乙型肝炎/联合免疫/孕妇/婴儿/乙肝表面抗体/乙型肝炎e抗原Key words
chronic hepatitis B/combined immunization/pregnant women/infant/anti-HBs/HBeAg分类
医药卫生引用本文复制引用
王新蕊,朱博,丰丽娟,郭春霞,张晓飞,张雅楠,曹晓蕾,杨莉,赵玉婵,戴二黑..HBeAg阳性高病毒载量慢性乙型肝炎孕妇分娩婴儿联合免疫后抗-HBs应答水平影响因素研究[J].现代中西医结合杂志,2025,34(8):1057-1062,6.基金项目
河北省医学科学研究课题(20221686) （20221686）
石家庄市科技支撑计划项目(2414608603) （2414608603）
