江苏地区HBsAg-/HBV DNA+献血者血清学和分子生物学特点分析

Serological and molecular characteristics of HBsAg-/HBV DNA+ blood donors in Jiangsu

目的了解江苏地区HBs Ag-/HBV DNA+献血者感染的HBV血清学及其HBV DNA S区分子生物学特点。方法选取2013年度常规初筛HBs Ag阴性、NAT阳性标本,经化学免疫发光法检测HBV感染的血清学指标,确认HBs Ag-/HBV DNA+标本48例;采用巢式PCR扩增HBV DNA S区,对测序结果进行基因型、血清型及其突变分析;用SPSS 11.0软件比较HBV基因型和血清型的分布,并分析献血者感染的HBV基因型、血清学和病毒特征之间的关系。结果江苏地区HBs Ag-献血人群HBV DNA+感染率为0.6‰。48例标本血清病毒载量<20 IU/m L-2 510 IU/m L。43例标本成功扩增出HBV S区基因,根据测序结果分析共有B型21例、C型19例和D型2例,未能定型1例;其血清型共3种包括:19例adr;23例adw(adw2,21;adw3,2);1例ayr。献血者HBV血清学特征、年龄、性别、ALT值以及病毒载量与基因型均之间均无相关性。8例(18.6%)标本发生突变,其HBV"a"决定簇的突变位于Q111R/H,S117C,G119R,T126M,Q129L/H/P,G130R,N133R,F134L,C147Y。结论江苏地区HBs Ag-/HBV DNA+献血者感染的HBV多为低病毒载量的隐匿性感染,其基因型以B型为主,其次是C型;adw为主要血清型。HBV S区的突变与HBs Ag-/HBV DNA+或OBI之间的关系有待进一步调查。

Objective To study the characteristics of serology and HBV DNA S region among HBsAg -/HBV DNA ＋ blood donors in Jiangsu. Methods A total of 48 HBsAg -/HBV DNA ＋ blood samples were confirmed by Chemilumines- cence immunoassay. These blood samples were selected from HBsAg negative and NAT positive blood donors in 2013. The S region of HBV was amplified by nested PCR and sequenced. HBV subgenotype and serotype was determined. The SPSS 11.0 software was used to compare the distribution of HBV genotype and serotype and to analyze the relationship among the geno- type, serological and viral characteristics of HBV in blood donors. Results The prevalence of HBsAg -/HBV DNA ＋ blood donors in Jiangsu was 0.6‰. Viral loads in 48 samples were less than （2 000 -2 510） IU/mL. Of 48 samples, forty-three were amplified successfully. The major genotypes of HBV in Jiangsu blood donors were genotype B （21）, genotype C （19） and genotype D （2）, while one could not be determined. There were 3 serotypes, including 19 adr,23 adw and 2 ayr. There was no significant difference anaong serological markers, gender, age, ALT, viral loads and genotypes. Mutations in 8 （18. 6%） samples were mainly Q111R/H, S117C, G119R,T126M, Q129L/H/P, G130R, N133R, F134L and C147Y. Conclusion HBsAg -/HBV DNA ＋ blood donors in Jiangsu were mostly infected with low load of HBV and presented as occult infection. HBV genotype B and serotype adw were the most frequent strain circulating in HBV infected Jiangsu blood donors. The relationship of the mutations in S regions and the occurrence of HBsAg -/HBV DNA ＋ or OB1 needs further investigation.