乙型肝炎病毒核酸检测降低输血感染残余风险的初步评估

Preliminary evaluation of reducing residual risk of blood transfusion-transmitted infection by using HBV DNA detection

目的 评估衢州地区开展核酸检测技术（NAT）后,无偿献血血液经酶联免疫吸附试验（ELISA）检测合格后的输血传播乙型肝炎病毒（HBV）残余风险的减少程度.方法 以衢州市中心血站检验科2016年3月至2017年3月期间无偿献血者血液标本为样本,分别采用两种不同厂家的ELISA试剂和一种厂家的NAT试剂检测,用风险评估模型计算HBV的输血残余风险.结果 2016年3月至2017年3月期间共27 646份标本,ELISA检测为阳性,NAT检测也为阳性的标本有76例;ELISA检测为阴性,NAT检测为阳性的标本有31例;NAT检测阳性的标本一共有107例.ELISA检测后的输血HBV残余风险为28.2 × 10-5,NAT检测后的输血HBV残余风险为13.0×10-5.结论 NAT检测可较大幅度地减少HBV的输血感染残余风险,为进一步确保临床输血安全提供有效价值.

Objective To evaluate the reduction of the residual risk of blood transfusiontransmitted hepatitis B virus （HBV）,using nucleic acid detection （NAT）test for enzyme linked immunosorbent assay （ELISA） qualified volunteer-donor bloods in Quzhou area after NAT was developed.Methods Specimens were collected from March 2016 to March 2017,detected by ELISA twice with two different reagents and NAT only once.The residual risks of blood transfusion-transmitted HBV infection were calculated by mathematical model of risk evaluation.Results Totally 27 646 specimens were collected from March 2016 to March 2017,which included 76 specimens that were both ELISA and NAT positive,31 specimens were ELISA negative but NAT positive.The total number of NAT positive specimens was 107.The residual risk of HBV by ELISA test was 28.2 × 10-5and NAT test was 13.0 × 10-5.Conclusions NAT detection can greatly reduce the residual risk of blood transfusion-transmitted HBV infection,and provide effective value for bloods safety in practice.