摘要
目的分析乙型肝炎病毒(hepatitis B virus, HBV)(简称乙肝)表面抗原(HBsAg)酶联免疫法(ELISA)检测阴性献血者血液输血存在乙肝病毒(HBV)感染的残余风险,评价其感染状况。方法选择初筛合格的45 551份无偿献血者样本,采用2种不同的ELISA试剂盒进行HBsAg检测,同时三联荧光病毒单人份核酸扩增检测技术(NAT)检测HBV、丙型肝炎病毒和人类免疫缺陷病毒-1,并对有反应的样本再进行核酸鉴别试验来检测病毒类型,对HBsAg-ELlSA阴性且NAT单反应(HBsAg-/HBV DNA+)样本进行HBV定量和血清学检测。结果共检出44份HBsAg-/HBV DNA+样本,42份为隐匿性HBV感染(OBI),2份为窗口期感染(WP)。OBI发生率0.90‰,32份OBI样本HBV DNA定量小于20 IU/ml,OBI检出率不同性别、年龄及献血次数人群间差异有统计学意义(P〈0.05)。血清学检测OBI样本存在6种模式,HBcAb阳性最多39份92.9%(39/42),其中HBcAb阳性样本中76.9%(30/39)HBV DNA定量小于20 IU/ml;29.5%(13/42)的OBI献血者HBeAb和HBcAb同时阳性,其中84.6%(11/13)HBV DNA定量小于20 IU/ml。
结论HBsAg-献血者部分NAT单反应献血者为HBV感染者,多以OBI为主,且HBV DNA浓度低,屏蔽NAT单反应样本对预防经输血传播HBV具有重要意义。
ObjectiveTo analyze the residual risk of transfusion transmitted hepatitis B virus (HBV) infection by enzyme-linked immunosorbent assay (ELISA) method in hepatitis B surface antigen (HBsAg) negative blood donors, and to assess the infection status.MethodsA total of 45551 samples were collected from blood donors.All samples were tested by 2 different ELISA kids of HBsAg and nucleic acid testing (NAT) individually of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Those ELISA HBsAg negative and NAT single reactive (HBsAg-/HBV DNA+ ) specimens were analyzed by quantitative detection of HBV DNA and by serologic testing of HBV antigen and antibody.ResultsA total of 44 HBsAg-/HBV DNA+ samples were detected, including 42 occult HBV infections (OBI) and 2 window period infections (WP). The detection rate of OBI rate was 0.90‰, and 32 samples of OBI sample HBV DNA was less than 20 IU/ml, and the OBI detection rate was significantly different between different genders, ages and blood donation times (P〈0.05). In the OBI sample, there were 6 serological models, 92.9%(39/42) OBI samples hepatitis B core antibody (HBcAb) positive, and 76.9%(30/39) HBV DNA in HBcAb positive samples were less than 20 IU/ml; 29.5% (13/42) of OBI blood donors hepatitis B e antigen (HBeAb) and HBcAb were also positive, of whom 84.6% (11/13) were HBV DNA quantitatively 〈20 IU/ml.ConclusionsHBV residual risk of transfusion-transmitted infection may occur through HBsAg- and single NAT reactive blood donors, mainly include OBI, and HBV DNA low level. Blocking of single NAT reactive blood donors could reduce transfusion-transmitted HBV infection.
作者
徐利强
李建华
倪修文
孙亚云
吴瑾惠
毛惠娜
Xu Liqiang;Li Jianhua;Ni Xiuwen;Sun Yayun;Wu Jinhui;Mao Huina(Jiaxing-Blood,Center,Jiaxing 314000,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2018年第4期407-410,共4页
Chinese Journal of Experimental and Clinical Virology
基金
嘉兴市社会发展领域研究与示范应用项目(2016AY23097)
关键词
献血者
乙型肝炎病毒
核酸检测
输血传播
隐匿性乙型肝炎病毒感染
Blood donors
Hepatitis B virus
Nucleic acid amplification technique
Transfusion transmitted
Occult hepatitis B virus infection