病毒核酸检测在献血者保留中的应用

The application of nucleic acid testing in keeping blood donor

目的了解安阳地区献血人群中,乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)用酶联免疫吸附法(ELASL)检测的假阳性情况,对无偿献血人群的血标本进行HBV和HCV核酸检测(NAT)的可行性评估。方法对无偿献血者血液样本50 267份开展ELISA检测,对乙型肝炎病毒表面抗原(HBsAg)和抗丙型肝炎病毒抗体(抗-HCV)阳性标本开展实时荧光定量PCR检测,并对ELISA单试剂(+)NAT(-)献血者6个月后进行追踪检测。结果两个项目两种ELISA试剂检测结果不相符率达46.7%,ELISA检测方法单试剂阳性者PCR呈阴性者249份,ELISA检测方法双试剂阳性者PCR呈阴性者103份。HBV项目单试剂阳性组与双试剂阳性组比较,差异有统计学意义(χ2=114.154,P<0.01);HCV项目单试剂阳性组与双试剂阳性组比较,差异有统计学意义(χ2=61.109,P<0.01)。ELISA单试剂(+)NAT(-)献血者有91名被追踪检测成功,其中83人检测结果为ELISA(-)NAT(-)。结论 NAT可有效的检测出无偿献血人群中ELISA检测方法呈阳性的阴性标本,应考虑在该地区无偿献血人群中进行NAT,以便更好地保留献血者,提高固定献血者比例。

Objective To find out the situation of Hepatitis B virus and Hepatitis C virus in Anyang city by analyzing false positive on ELISA method,and to assess blood samples of voluntary blood donors using detecting nucleic acid of HBV and HCV.Methods ELISA makes blood samples of 50 267 voluntary blood donors,and Real Time PCR tests positive specimens on HBsAg and antibody to HCV,and then blood donors whose results were single positive ELISA and negative NAT would be tracked after 6 months.Results The unmatch rate between two ELISA products in HBV and HCV tests was 46.7%.There were 249 specimens which showed positive in either of two ELISA tests but negative in PCR,and 103 samples that perform positive data in both ELISA products but negative PCR results.The χ2 was 114.154（P＆lt;0.01） between single and both positive HBV results,and this statistical item was 61.109（P＆lt;0.01） in HCV comparison.83 of 91 tracked men had ELISA（-）NAT（-） results.Conclusion Real Time PCR could distinguish effectively false positive ELISA results of voluntary blood donors.We should apply Real Time PCR to our volunteers for keeping current blood donors and improving regular ones.