献血者HEV感染合并HBV感染的特征分析

Analysis on Characteristics of HEV Co-infection with HBV among Blood Donors

目的探讨合肥地区献血者中戊型肝炎病毒合并乙型肝炎病毒感染情况与特征分析,分析其与HBsAg/HBV DNA检测结果的关系。方法随机抽取2021年7月1日—2023年2月25日无偿献血者标本1301份纳入研究对象,根据HBsAg和HBV DNA检测结果将标本分为3组,HBsAg阳性组169份标本、HBsAg阴性组102份标本、合格组1030份标本分别采用酶联免疫吸附试验(ELISA)检测血浆中HEV Ag、抗HEV-IgM和抗HEV-IgG。依据抗HEV抗体检测结果采用RT-PCR法对合格组标本100份、HBsAg阳性组标本20份、HBsAg阴性组标本30份进行HEV RNA检测。分析3组献血者中抗HEV-IgM和抗HEVIgG检测阳性献血者基本情况进行统计分析。结果3组1301份标本HEV Ag检测均为阴性。HBsAg阴性组检出抗HEV阳性率为22.55%,与HBsAg阳性组相比(22.55%vs 17.75%)差异无统计学意义(P>0.05);但与合格组相比(22.55%vs 13.79%),差异有统计学意义(P<0.05)。HBsAg阳性组和合格组均检出抗HEV-IgG+IgM抗体,阳性率分别为1.18%和0.29%,且合格组检出抗HEV-IgM抗体阳性率为0.39%。留取3组150份标本未检出HEV RNA。HBsAg阴性组随着献血者年龄的增长检出抗HEV抗体阳性率有升高趋势,但差异无统计学意义(P>0.05)。HBsAg阳性组和合格组抗-HEV抗体阳性率在41~50岁人群最高,分别为27.27%和27.04%,其次是51~55岁人群。1301份标本检出抗HEV抗体阳性男性献血者151人,阳性率16.74%,女性45人,阳性率11.28%,检出抗HEV阳性男女人数之比为3.5∶1,差异有统计学意义(P<0.05)。结论合肥地区献血者中存在HEV感染合并HBV感染,多为既往感染,也存在急性感染,HBV隐匿感染状态中HEV感染者居多。

Objective To investigate the characteristics of hepatitis E virus(HEV)and co-infection with hepatitis B virus(HBV)among blood donors in Hefei,and analyze the relationship between HEV and HBsAg/HBV DNA detection results.Methods A total of 1301 blood samples collected from voluntary blood donors in Hefei from July 1,2021 to February 25,2023 were randomly selected to be included in the study.According to HBsAg and HBV DNA detection results,they were divided into 169 HBsAg positive blood donors,102 HBsAg negative blood donors,1030 eligible blood donors.Plasma HEV Ag、anti HEV IgM and anti HEV-IgG were detected by enzyme-linked immunosorbent assay(ELISA)diagnostic kit.According to the results of anti-HEV antibody detection,100 qualified group specimens,20 HBsAg positive group specimens and 30 HBsAg negative group specimens were further detected by RT-PCR.The statistical analysis focused on the presence of anti HEV-IgM and anti HEV-IgG antibodies in the three groups.Results All 1301 samples from 3 groups were negative for HEV Ag.The positive rate of HBsAg negative group was 22.55%,compared with HBsAg positive group(22.55%vs 17.75%),there was no significant difference(P>0.05),but compared with the eligible blood donors(22.55%vs 13.79%),the difference was statistically significant(P<0.05).Anti HEV-IgM+IgG antibodies were detected in both the HBsAg positive group and eligible blood donors group,with positive rates of 1.18%and 0.29%,respectively.Meanwhile,the positive rate of anti-HEV-IgM antibody was 0.39%in the eligible blood donors.No HEV RNA was detected in the plasma of the three groups of donors.The positive rate of anti HEV antibody in the HBsAg negative group increased with age,and the difference was significant(P<0.01).In the HBsAg positive group,the positive rate of anti HEV antibody was the highest prevalent among 41 to 50 years(27.27%and 27.04%),followed by the aged 51 to 55 years.The positive rate of anti HEV antibody in different gender blood donors was 16.74%in males and 11.28%in females(P<0.05).The male were more frequent than females 3.5∶1 for HEV infection.Conclusion Hepatitis E virus co-infection among HBV DNA reactive blood donors in Hefei,mostly with past infection but also acute infection,and the majority HEV infectiont rate in the occult infection status of HBV.