31例乙型肝炎病毒核酸检测阳性献血者跟踪调查

A Follow-up Survey of 31 Cases HBV DNA Positive Cases of Blood Donors

目的了解扬州地区无偿献血者乙型肝炎病毒核酸检测阳性献血者的跟踪调查情况。方法对22518例献血者先经E LISA法两次检测及NAT一次检测;对本血站HBsAg E LISA法双试剂阴性或单试剂阳性而NAT检测为阳性的标本,再送江苏省血液中心进行罗氏核酸检测和乙肝"两对半"跟踪检测。对E LISA法HBsAg双试剂阴性核酸检测阳性献血者6个月后再进行跟踪检测。结果 ELISA法双试剂阴性标本中上海科华NAT检测为阳性26例,占0.12%;OBI感染22例,HBV窗口感染期4例。OBI献血者的血液学特征以HBcAb为主,占100.0%,其次为HBeAb,占63.6%。31例送检标本乙肝"两对半"均出现HBsAg、HBsAb、HBeAb、HbcAb单项或合并阳性。结论核酸检测能够在一定程度上弥补ELISA方法学的局限性,有效缩短窗口期,减少漏检的发生,降低经输血途径传播疾病的风险,从而确保血液质量和输血安全。

Objective To track the voluntary blood donors who showed positive hepatitis B virus DNAs to ensure blood transfusion safety. Methods 22 518 cases of blood donors were subjected to repeated ELISA testing and NAT detection. The NAT-positive samples that showed negative HBsAg by repeated ELISA but positive HBsAg by single ELISA were checked by both DNA detections and routine profile tests for HBV infection. The individuals with negative repeated ELISA but positive DNA detection were followed-up after 6 months of primary examinations. Results 0.12 % cases presented positive NAT although they were negative when tested by repeated ELISA. Among them,22 cases were OBI infections and 4 fell in window phase of HBV infection. All of the OBI donors were characterized by positive HBcAb（100%）,followed by HBeAg （63.6%）.All of the 31 samples exhibited single or combined positivity of routine profile tests for HBsAg,HBsAb,HBeAb,or HbcAb. Conclusion DNA detection may cover the shortage of ELISA,shorten the window phase,and avoid misdiagnosis so as to reduce the risk at transmission of infectious diseases.