HBV-DNA检测在饮服从业人员筛查中的意义

Significance of HBV-DNA detection to evaluating the infectivity of employees in food and public services with HBV infection

目的 :检测感染 HBV饮服人群的 HBV- DNA,研究 HBV- DNA阳性者的家庭聚集性 ,探讨其传染性 ,为修订有关法规、采取有效控制措施提供依据。方法 :用反向间接血凝法检测HBs Ag,用赖氏法检测 AL T,酶联免疫吸附试验检测 HBs Ag、抗 - HBs、抗 - HBc、HBe Ag、抗 - HBe。聚合酶链反应 -微孔杂交法和荧光定量 PCR法检测 HBV- DNA。并对 HBV- DNA阳性者的家庭聚集性进行对照研究。结果 :HBs Ag阳性 10 2 2人 ,阳性率 3.5 8%。其中 HBs Ag≥ 1∶ 5 12或 AL T>4 0者 2 37人 ,占阳性者的 2 3.19%。 AL T<4 0、 HBs Ag<1∶ 5 12 ,且 HBe Ag阳性者 12 7人 ,占16 .18%。在 HBs Ag<1∶ 5 12、AL T<4 0、且 HBe Ag阴性的 6 5 8人中检出 HBV- DNA阳性者 2 34人 ,阳性率 35 .5 6 %。HBV- DNA阳性者的家庭聚集率为 86 .4 9% ,家庭成员 HBV感染率为 6 4 .38% ,相对危险性 6 .5 8。HBV- DNA阳性者的家庭成员 HBV感染呈家庭聚集性。结论 :血清学检验结果同时表现为 HBs Ag<1∶ 5 12、AL T<4 0、HBe Ag阴性、HBV- DNA阳性的在岗饮服人员是 HBV的危险传染源。

Objective: To make the policy for controling and preventing hepatitis B on the basis of HBV infection among employees in food and public services. Method: 28516 employees were detected for serological marker of HBV infection, among which HBsAg was detected by RPHA,HBVM by ELISA,HBV-DNA by PCR, microcell hybridization and fluorescence-based quantitative analysis. Familial clustering of HBV infection was analysed with the fitness comparison by binomial distribution.Results:1 022 employees were HBsAg positive, with rate of 3.58%,among whom 237 employees titers of HBsAg was more than 1∶512 and titers of ALT was more than 40,with rate of 23.19%, 127 employees HBeAg were positive,with rate of 16.18%, However there were 234 employees HBV-DNA positive from 658 employees with HBsAg <1∶512, ALT<40, and HBeAg negative with rate of 35.56%.For familial clustering rate of HBV infection individuals was 86.49% and the rate of intrafamilial HBV infection was 64.38%.Conclusion: HBV-DNA positive employees with HBsAg <1∶512, ALT<40,and HBeAg negative were still potential spreading sources of HBV.