·综述·乙型肝炎病毒垂直传播机制及其易感因素.pdfVIP

际生殖健康/ 计划生育杂志 20 10 年 7 月第29 卷第 4 期 J Int Reprod Health Fam Plan ，July 20 10熏 Vol. 29熏 No. 4 295 综述 型肝炎病毒垂直传播机制及其易感因素 旭平综述 朱依敏审校 【摘 要】 乙型肝炎病毒（HBV ）可经多种渠道传播，垂直传播是其主要传播途径，其中又以产前传 播为主。产前传播可分为经胎盘传播和经生殖细胞传播。临床上使用高效免疫球蛋白（HBIG ）联合乙型肝 炎疫苗阻断携带HBV 的妊娠妇女及其新生儿间的传播，但有部分患者免疫失败。近年研究证实，HBV DNA 可以游离或整合的形式以人生殖细胞为载体实现病毒的垂直传播。已证实，妊娠妇女血清HBV DNA 含量、病毒变异体和遗传易感性等是引起垂直传播阻断失败的因素，即病毒垂直传播的易感因素。 【关键词】 乙型肝炎病毒；疾病传播, 垂直；生殖细胞；危险因素 The Mechanism and Susceptibility of Hepatitis B Virus Vertical Transmission ZH OU Xu p ing, ZH U Yi min. The Women ’s Hosp ital, School of Medical, Zhej iang Univ ers ity, H angz hou 310006, China Corresp onding author: ZH U Yi鄄min ，E鄄mail: z huyim@zj u. edu. cn 【Abstract 】 Hepatitis B virus can be transmitted either horizontally or vertically among human beings and the latter is the major rout for HBV infection. Perinatal infection takes a great part in vertical transmission, which consists of transplacental transmission and transmission through germinal cells. Clinically, people use HBIG （hepatitis B immune globulin) and recombinant hepatitis B （rHB ）vaccine in the prevention of vertical transmission if the expectant mother is positive of hepatitis B surface antigen （HBsAg ）in serum, but the infection can not be prevented thoroughly. HBV DNA can either integrate or dissociate in sperm and oocyte chromosomes and infect the offsprings. The hepatitis B virus DNA load, virus variant and genic susceptibility to virus infection are now considered to be the risk factors for HBV vertical transmission. This review focuses on the mechanism and susceptibility of hepatitis B virus vertical transmission. 【Key words 】 Hepatitis B virus ；Disease transmission, vertical ；Germ cells ；Risk factors 渊允 陨灶贼 砸藻责则燥凿 匀藻葬造贼