256例ELISA筛查无反应性/核酸检测反应性标本的确认分析

Confirmatory analysis of 256 NAT reactive and ELISA non-reactive blood donation samples

目的对ELISA筛查无反应性而核酸检测反应性(ELISA-/NAT+)标本进行结果确认及部分献血者追踪随访分析,以明确真正感染状态,给予献血者较明确的解答。方法对2010年6月-2015年7月间,常规血液筛查为ELISA-/NAT+的256份标本进行HBs Ag、抗-HBs和抗-HBc化学发光法检测,HBV DNA/HCV RNA/HIV RNA定量检测,对定量检测阳性、化学发光法检测无反应性献血者进行追踪随访。结果在256例ELISA-/NAT+献血者标本中,确认248例为HBV感染者,4例窗口期HIV感染者,1例窗口期HCV感染者,3例假阳性。在248例HBV感染者中,201例确认为隐匿性HBV感染者,22例为窗口期HBV感染者;25例为慢性乙肝病毒感染、感染恢复期或病毒携带者。确认结果回告给献血者,并告知处理办法,得到了满意的结果。结论核酸检测在血站的运用检出的ELISA-/NAT+献血者中,绝大部分是HBV感染,其中尤以隐匿性乙肝感染为主。

Objective To confirm NAT reactive and ELISA negative blood donation samples and to follow up donors and provide them with specific and reasonable explanation regarding their infection status. Methods 256 NAT reactive and ELISA negative specimens were collected during June 2010 and July 2015. A series of additional tests, such as chemiluminescence assay of HBsAg, anti-HBs and anti-HBc, HBV DNA/HCV RNA/HIV RNA quantity tests as well as a follow up on donors were conducted. Results Among 256 NAT reactive specimens, 248 were confirmed as HBV infections, while 4 HIV and 1 HCV case were identified to be in window period, in addition to 3 false reactive ones. Among 248 HBV infection cases, 201 were occult HBV infection cases, 22 were HBV window period cases and 25 were chronic HBV infections carriers or were in the midst of infection recovery. Finally, the confirmation results and treatments were explained to donors. Conclusion The application of NAT in blood bank helps screen out HBV infection cases, especially individuals with occult HBV infection.