Association of TNF-α-308 gene polymorphisms with failure of blocking of mother-to-infant transmission of hepatitis B
OBJECTIVE To investigate the effect of tumor necrosis factor-α(TNF-α)-308 gene polymorphism on the effectiveness of mother-to-child transmission interruption of hepatitis B,and to construct a risk factor model.METHODS The clinical data of 895 pregnant women and their newborns who underwent maternal-to-child trans-mission interruption treatment for hepatitis B at Longyou County Central Hospital from Jan.2021 to Jan.2023 were retrospectively analyzed.According to the treatment effect,those who failed immunoblocking were included in group A(61 cases),and those who succeeded in immunoblocking were included in group B(834 cases).The TNF-α-308 gene polymorphism of the two groups was analyzed,and multiple factor logistic regression analysis was used to analyze the risk factors for the failure of mother-to-child transmission blockade of hepatitis B,and a prediction model was constructed,and the receiver operating characteristic(ROC)curve was drawn to analyze its predictive value for the failure of mother-to-child transmission blockade of hepatitis B.RESULTS Compared with group B,group A had a higher frequencies of TNF-α-308 A/A genotype and A allele(P＜0.05).Maternal pre-pregnancy body mass index(BMI),postpartum serum alanine transaminase(ALT),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-4(IL-4),hepatitis B e antigen(HBeAg),hepatitis B surface antigen(HBsAg)and plasma hepatitis B virus deoxyribonucleic acid(HBV DNA)load were higher than those in group B,and post-partum serum interleukin-18(IL-18)were lower than those in the group B(P＜0.05).The results of multivari-ate logistic regression analysis showed that the risk factors of failure of mother-to-child transmission interruption of hepatitis B included postpartum ALT,HBeAg,HBsAg and plasma HBV DNA load,TNF-α-308 A/A geno-type and A allele(P＜0.05).The model of regression equation was constructed as:Logit(P)=-12.032+the level of postpartum ALT×1.032+the level of HBeAg × 0.983+the level of HBsAg × 0.673+plasma HBV DNA load × 1.657+TNF-α-308 A/A genotype × 0.976+TNF-α-308 A allele × 1.373.The ROC curve showed that,when Logit(P)＞13.26,the area under the curve(AUC)value was 0.859 with 95％CI of 0.834-0.881,and the diagnostic sensitivity was 70.49％,and the specificity was 87.17％.CONCLUSION The effect of mother-to-child transmission interruption of hepatitis B was closely related to the polymorphism of the TNF-α-308 gene,and the risk factors for blocking failure included maternal postpartum serum ALT,HBeAg,HBsAg and plasma HBV DNA load,TNF-α-308 A/A genotype and the A allele,based on which the regression model con-structed had a high predictive value,and the clinic could give the targeted preventive and therapeutic measures to improve the effect of interruption.
Hepatitis B virusMother to child transmissionBlocking effecstFailure of blockingTumor necro-sis factor-α-308
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