对HBsAg阴性无偿献血乙型肝炎感染者的追踪研究

Detection of HBV DNA Positive and HBsAg Negative Blood Donors: A Follow-up Study

目的了解和分析HBsAg阴性无偿献血者乙型肝炎感染状况。方法应用罗氏聚合酶链反应（PCR）定量检测方法追踪6位HBsAg阴性，DNA阳性感染者的病毒载量，同时对进行基因分型、血清转换及ALT等多项指标的的动态追踪分析观察。结果6例阳性样本经过至少40d追踪发现，3例发生了血清转换现象；DNA定量追踪分析表明，病毒载量在（35～1．8）×10^4拷贝／ml之间，1例为急性乙型肝炎感染，病毒载量峰值为1．8×10^4拷贝／ml，3例呈低水平携带状态，病毒载量在100～500拷贝／ml之间波动；1例病毒载量下降至检不出，而HBsAg转换成阳性；最后1例间或能检出病毒，载量〈100拷贝／ml。结论本实验结果认为有必要进行献血者HBV核酸筛查工作，进一步提高输血安全性。

OBJECTIVE To investigate and analyze the kinetics of serological marks and virus load of the follow-up blood donors. METHODS The quantitation of HBV DNA of 6 HBsAg negative and DNA positive blood donors was detected by Roche PCR Monitor,and the donors were genotyped and traced by serological tests. RESULTS Three of 6 follow-up donor samples were seroconverted after more than 40 days follow-up study. The viral loads were with range of （35-1.8） × 10^4 copies/ml, 1 of 6 donors had acute infection, the peak load was 1.8 ×10^4 copies/ml, 3 of 6 were with lower level HBV carrier with fluctuating viral load ranged 100-500 copies/ ml. One donor had decreasing viral load,when HBsAg converted to positive,virus wasn＇t detected. The last one had fluctuating virus load below 100 copies/ml, intermittently falling below the threshold of the assay. CONCLUSIONS It is necessary to implement HBV DNA detection for blood screening, and further strengthen the Safety of blood transfusion.