ABSTRACT
Objective To explore the relationship between HBV-DNA load and the offspring vertical transmission of HBV.Methods 138 families who had taken the examination between August 2009 and November 2011 but the HBsAg of the housewife was negative,were chosen as research objects.Blood from the couples and sperms from the husbands during pregnancy were followed and collected for detection on related indicators.Cord blood was sampled after delivery for HBVM and HBV-DNA quantification.Those with HBV-DNA load ≥5 × 102 copies/ml were chosen as cases while those ＜5 × 102 copies/ml were formed as controls,respectively.Results 1) The positive rates of HBV-DNA was 34.8％ (48/138) in the neonatal cord blood while the positive rates of cord blood HBsAg and HBeAg were 28.3％ (39/138) and 15.2％ (21/138) respectively.2) The positive rate of semen HBV-DNA was 21.0％ (29/138) while the positive rates of paternal serum HBV-DNA and HBeAg were 76.8％ (106/138)and 42.8％ (59/138).3)Among the positive ones on paternal serum HBV-DNA,paternal serum HBeAg,semen HBV-DNA,items as measures taken for HBV vertical transmission and prevention on the fathers and the first class family histories on HBV appeared to be the risk factors for HBV paternal transmission (P＜0.05).4)Data from Multivariate analysis showed that positivities on patemal serum HBV-DNA,paternal serum HBeAg and semen HBV-DNA were risk factors for HBV paternal transmission (OR=5.7,95％CI:1.1-29.1 ; OR=4.2,95％CI:1.7-10.0; OR=6.7,95％ CI:2.4-18.9).5)Dose-response relationships were seen between levels of paternal serum HBV-DNA load and cord blood HBV-DNA load,between levels of paternal serum HBV-DNA load and semen HBV-DNA load,between levels of semen HBV-DNA load and cord blood HBV-DNA load.6)Results from the analysis on ROC curve showed that paternal serum HBV-DNA load level (105 copies/ml) and semen HBV-DNA load level (103 copies/ml)were better demarcation points to forecast the occurrence of paternal transmission of HBV,because of the better sensitivity and specificity they had.Conclusion Items as positives on paternal serum HBV-DNA,paternal serum HBeAg and semen HBV-DNA were risk factors for HBV paternal transmission.When paternal serum HBV-DNA load ＞ 105 copies/ml and semen HBV-DNA load ＞ 103 copies/ml appeared,the positive rate of HBV paternal transmission would increase.
ABSTRACT
Objective To explore the risk factors of and the influence of different hepatitis B virus (HBV) DNA load on paternal vertical transmission of HBV.Methods Totally,161 HBsAg negative women,whose husband was HBsAg positive,attended the antenatal clinics of the Provincial Maternity and Child Health Hospital of Fujian from September 2007 to December 2008 and their newborns were selected,and the epidemiologic information,the duration of being a HBV carrier,the first class HBV family history of the fathers,HBV markers,HBV DNA load,HBsAb of the gravidas,the outcomes of the newborns were all collected.Cord blood was sampled after delivery for HBV DNA quantification and those with HBV DNA load ≥1.0×103 copy/ml were chosen as the case group and those ＜ 1.0×103 copy/ml as control.Results (1) Among the 161 newborns,36 HBV DNA positive cord blood samples were detected,giving a rate of 22.4% (36/161) for paternal vertical transmission of HBV.The HBV DNA positive rate in cord blood was 32.0% (23/72) in HBeAg-positive fathers and 14.6% (13/89) in HBeAg-negative fathers.(2) Univariate analysis showed that HBeAg-positive,HBV DNA positive,first class family history of HBV and the duration of being a HBV carrier of the fathers were risk factors of paternal HBV vertical transmission[X2= 6.892,29.916,29.499 and 23.821,OR = 2.7,5.2,8.3 and 1.4 (P＜0.01)].(3) Multivariate analysis found that paternal serum HBV DNA positive and the first class family history of HBV of the father side were risk factors of paternal vertical transmission of HBV (OR = 11.1,95% CI;4.6-27.1;OR = 17.1,95% CI:3.5-82.6).(4) According to the different serum HBV DNA load of the HBsAg-positive father,7 groups were divided.A dose dependent effect was found that the HBV DNA positive rate of the cord blood increased with the rising of HBV DNA load.No HBV DNA positive cord blood was detected when paternal HBV DNA load was＜1.0×104 copy/ml,while 100% of the cord blood were positive when paternal HBV DNA load≥1.0×108 copy/ml.(5) The average birth weight of the newborns in the two groups was the same (3.3±0.4) kg.And the delivery mode,gestational age at delivery,height and Apgar score of the newborns at 1 minute,neonatal pathological jaundice and other complications had no significant difference between the two groups (P ＞ 0.05).No relationship was found between the neonatal outcomes and the paternal HBV vertical transmission (P＞0.05).Conclusions HBV DNA load in the serum of HBsAg-positive father,and the paternal first class family history of HBV are risk factors of paternal HBV vertical transmission.When the serum HBV DNA load in HBsAg-positive father is≥1.0×107 copy/ml,the possibility of paternal vertical transmission of HBV would increase.
ABSTRACT
Objective To evaluate the long-term results of rapamycin eluting stent in patients with coronary heart disease.Methods From Dec. 2001 to Nov. 2002, 143 patients were treated with 173 rapamycin eluting stents. Sixteen stents were implanted directly, the others were implanted with pre-dilation. Post-dilations were performed in 52 stents. All patients were administered aspirin and clopidogrel regularly before and after the procedures. Results Procedural succees rate reached 99.3% with completion of the follow-up in 138 patientes averaging (12.8 ?4.3) months. Thirteen patients has suffered with recurrent angina and 1 had acute myocardial infarction. Thirty eight patients received repetition of coronary angiography within 6 to 12 months after the procedure. Five patients showed instent restenosis, of which 4 received target lesion revascularization. The restenosis rate was 13.2% by angiography.Conclusion Rapamycin eluting stent can be used safely and effectively in patient with coronary heart disease, having long-term effect to reduce the restenosis rate after PCI.