乙型肝炎病毒医院感染阈值及实用价值

Threshold value of hepatitis B virus cross-infections and its practical value

目的测定医务人员和患者在乙型肝炎病毒医院感染过程中分别适合使用的防护阈值,探讨使用该阈值筛查和控制传染源应该采用的病毒标志和适合使用的防护方法。方法定量检测HBsAg携带者的传染性,确定HBV交叉感染阈值,选择传染源替代指标,制定医院感染监控方法。结果将HBsAg携带者分为HBeAg阳性者和阴性者两个部分;156例HBsAg携带者中115例HBV-DNA阳性,阳性率73.7%,传染性范围0～109 ID/ml;31例HBeAg阳性者的HBV-DNA均阳性,传染性范围102～109 ID/ml;125例HBeAg阴性者中84例HBVDNA阳性,阳性率67.2%,传染性范围0～106 ID/ml,所有HBeAg阳性和26.4%HBeAg阴性者的HBV浓度≥102 ID/ml,所有HBeAg阴性和54.8%HBeAg阳性者的HBV浓度<107 ID/ml。结论 HBV经交叉感染患者的阈值为102ID/ml,适合采用HBsAg监控法进行预防;经交叉感染医务人员的阈值为107 ID/ml,适合使用HBeAg监控法进行预防。

OBJECTIVE To determine the threshold value and practical value of hepatitis B virus （HBV） cross-infections respectively used by the medical staff and patients and establish an eligible protective method which can be used to screen and control sources of infections. METHODS The infectivity of HBsAg carriers was quantitatively detected to determine the threshold value of HBV cross infections, the surrogate markers of the infection sources were selected, and the monitoring methods were put forward. RESULTS The HBsAg positive patients were divided into two groups according to the HBeAg positive or negative. Among all the 156 HBsAg positive patients, there were 115 cases of patients with HBV-DNA tested positive, the positive rate was 73.7%, with the infectivity ranging between 0 and 109 ID/ml; all the 31 HBeAg-positive patients were tested positive for HBV-DNA, with the infectivity ranging between 102 ID/ml and 109 ID/ml; of 125 HBeAg-negative patients, there were 84 cases with the HBV-DNA tested positive, the positive rate was 67.2%, with the infectivity ranging between 0 and 10^6 ID/ ml, the HBV concentration of all the HBeAg-positive patients and 26.4% of the HBeAg-negative patients were more than 102 ID/ml, and the HBV concentration of all the HBeAg-negative patients and 54.8% of the HBeAg- positive patients were less than 107 ID/ml. CONCLUSION The threshold value of the HBV cross-infection patients is 102 ID/ml, it is suitable for prevention with monitoring of HBsAg~ the threshold value of the medical staff with HBV cross-infection is 107ID/ml, and it is suitable for prevention through monitoring of HBeAg.