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目的探讨HBV携带孕妇血清HBV标志物与血清、乳汁中HBV-DNA含量之间的关系,评价母乳喂养的安全性。方法利用ELISA筛查乙肝五项至少一项阳性的孕妇血清HBV-M,将其分为HBeAg阳性组和HBeAg阴性组共180例。同时应用荧光定量PCR对其血清和乳汁中的HBV-DNA进行检测。结果 HBeAg阳性组孕妇的血清和乳汁HBV-DNA阳性率为97.7%(88/90)和62.2%(74/90),HBV-DNA平均载量的对数量为7.32±1.83和4.02±1.21。HBeAg阴性组孕妇的血清和乳汁HBV-DNA阳性率为55.5%(50/90)和13.3%(13/90),HBV-DNA平均载量的对数量为5.62±0.93和3.32±0.51。孕妇血清中HBeAg阳性组其乳汁和血清中HBV-DNA阳性率及病毒载量与HBeAg阴性组差异有统计学意义(P<0.05)。结论 HBV携带孕妇的血清中HBV-DNA载量越高,其乳汁HBV-DNA含量越高;二者高度相关(r=0.932,P<0.01)。血清HBV载量高的孕妇最好不要进行母乳喂养。
Objective To investigate the relationship between serum HBV markers in pregnant women carrying HBV and HBV-DNA in serum and breast milk to evaluate the safety of breastfeeding. Methods Serum HBV-M was detected by ELISA in at least one positive pregnant woman of hepatitis B, and divided into HBeAg-positive group and HBeAg-negative group (180 cases). At the same time, fluorescence quantitative PCR was used to detect HBV-DNA in serum and milk. Results The positive rates of HBV-DNA in serum and milk of HBeAg-positive pregnant women were 97.7% (88/90) and 62.2% (74/90), respectively. The mean HBV-DNA pairs were 7.32 ± 1.83 and 4.02 ± 1.21. The positive rates of serum HBV-DNA in serum and milk of HBeAg-negative pregnant women were 55.5% (50/90) and 13.3% (13/90), and the mean HBV-DNA pairs were 5.62 ± 0.93 and 3.32 ± 0.51, respectively. The positive rates of HBV-DNA in serum and serum of HBeAg-positive pregnant women and the difference between viral load and HBeAg-negative group were statistically significant (P <0.05). Conclusion HBV-DNA levels in the serum of pregnant women with HBV carriers are higher, and their HBV-DNA content in breast milk is higher. The two are highly correlated (r = 0.932, P <0.01). It is best not to breastfeed pregnant women with high serum HBV load.