混样核酸检测HBV拆分阴性标本的血清学标志物分析

An Analysis of HBV Serological Markers in the Samples of Positive Minipool NAT with Negative Resolution NAT

目的探讨混样核酸检测HBV拆分阴性的献血者标本是否存在低浓度HBV DNA.方法检测并比较混样核酸检测HBV拆分阴性标本与正常标本、HBV DNA拆分(+)/HBV DNA定量(-)三种标本的HBV血清学标志物(HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe)的电化学发光检测结果;对HBV拆分阴性者增加1遍拆分.结果①693例混样核酸检测HBV拆分阴性标本中:单独抗-HBs 239例,抗-HBs/抗-HBc 134例,抗-HBs/抗-HBe/抗-HBc 111例,单独抗-HBc 25例,抗-HBe/抗-HBc 9例,HBV血清学标志物阳性率74.75%(518/693),虽与正常标本阳性率(71.00%)的差异无统计学意义,但抗-HBs和抗-HBs/抗-HBc模式的占比与正常标本存在差异.②275例HBV DNA拆分(+)标本中有119例HBV DNA定量检测为(-),其中抗-HBe/抗-HBc 38例,抗-HBs/抗-HBc 30例,抗-HBs/抗-HBe/抗-HBc 22例,单独抗-HBc 18例,单独抗-HBs 3例,HBsAg/抗-HBe/抗-HBc 4例,其HBV血清学标志物阳性率为96.64%(115/119),与混样核酸检测HBV拆分阴性标本的差异有统计学意义,但抗-HBs/抗-HBc和抗-HBs/抗-HBe/抗-HBc模式的占比与混样核酸检测HBV拆分阴性标本的差异无统计学意义.③29次2次拆分中有6次可以检出HBV DNA.结论当混样核酸检测HBV拆分阴性标本存在抗HBs伴抗HBc时,可能有HBV感染风险.

Objective To investigate blood donor samples of positive minipool-HBV NAT(MP-HBV)but negative resolution HBV NAT(resolution-HBV)whether contain trace HBV DNA.Methods Samples of positive MP-HBV but negative resolution-HBV,and positive resolution-HBV but negative quantitative HBV,and normal samples,were measured by electrochemiluminescence assay(ECLIA)for HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc.The resolution NAT was executed once more when resolution NAT was negative.Results Among 693 samples of positive MP-HBV with negative resolution-HBV,239 showed only anti-HBs,134 demonstrated anti-HBs/anti-HBc,111 with anti-HBs/anti-HBe/anti-HBc,25 with only anti-HBc and 9 with anti-HBe/anti-HBc.No significant difference of the seroprevalence was noted between these samples(74.75%)and normal samples(71.00%).There were 119 of 275 resolution-HBV positive samples that presented quantitatively HBV negative.Among them,38 showed positive anti-HBe/anti-HBc,30 were anti-HBs/anti-HBc,22 anti-HBs/anti-HBe/anti-HBc,18 were only anti-HBc,3 only anti-HBs and 4 were HBsAg/anti-HBe/anti-HBc.The HBV seroprevalence was 96.64%,which was higher than positive MP-HBV but negative resolution-HBV samples.Six of 29 secondary resolution NAT revealed positive HBV DNA.Conclusion There may exist HBV infection in positive MP-HBV but negative resolution-HBV samples with anti-HBs/anti-HBc.