天津市HBV-DNA单独反应性献血者标本检测结果分析

Analysis of detection results of HBV-DNA single reactive blood donors in Tianjin area

目的总结无偿献血者血液筛查中HBV-DNA单独反应性标本的血清学模式,分析血清学非反应性的原因,探讨HBV-DNA单独反应性感染状态的人群背景资料的高危因素。方法对2017年3月-2018年2月期间献血者标本进行血清学ELISA检测HBsAg,同时采用TMA法检测HBV-DNA;对HBsAg(-)/HBV-DNA(+)的标本,测定血清学乙肝两对半其它4项;利用电化学发光免疫分析法(ECLIA)对HBsAg(-)/HBV-DNA(+)标本进行HBsAg检测;运用Logistic回归分析方法分析HBV-DNA单独反应性人群的相关资料。结果经常规血液筛查后,共检测出HBsAg(-)/HBV-DNA(+)标本135例;135例标本利用ECLIA检测HBsAg,7例(5.19%)为HBsAg(+);128例HBsAg(-)/HBV-DNA(+)标本根据乙肝两对半检测血清学表达形式,归纳分为7种模式;128例标本中抗-HBs阳性率58.59%(75/128),抗-HBc阳性率47.66%(61/128);Logistic回归分析结果显示,献血者出生年份和是否重复献血2个因素为HBV-DNA单独阳性感染状态的相关危险因素。结论HVB-DNA单独阳性标本血清学HBsAg(-)的主要原因是OBI感染和HBV感染"窗口期";各地区HBV-DNA阳性献血人群中血清学标志物表达模式有差别,天津地区抗-HBs和抗-HBc阳性率较高;ECLIA能降低ELISA漏检HBsAg风险;92年以前出生的献血者群体及初次献血的人群HBV-DNA单独反应性感染状态的几率较高。

Objective To summarize the serological marker patterns of HBV-DAN single reactive samples in blood screening of voluntary blood donors,analyze the reasons for non-reactive in serology tests,and explore the characterization of HBV-DNA single reactive donors.Methods The serum ELISA and NAT were used to detect HBsAg and HBV-DNA of blood samples collected from March 2017 to February 2018;HBsAg(-)/HBV-DNA(+)samples were detected for other four serum markers for HBV infection by ELISA;the electrochemiluminescence immunoassay(ECLIA)was used to detect HBsAg(-)/HBV-DNA(+)specimens for HBsAg;the risk factors of HBV-DNA single reactive blood donors was analyzed by Logistic analysis.Results 135 HBsAg(-)/HBV-DNA(+)specimens were found after blood screening.ECLIA test for HBsAg detection was performed on 135 specimens,and 7 reactive cases(5.19%)were found.HBsAg(-)/HBV-DNA(+)specimens were classified into 7 modes according to HBV Markers[HBsAg,anti-HBc,anti-HBs,hepatitis B e antigen(HBeAg),and anti-HBe].The positive rate of anti-HBs and anti-HBc were 58.59%(75/128)and 47.66%(61/128),respectively.The results of Logistic analysis showed that two factors,i.e.the year of birth of the blood donor and repeated donation or not,were related to the risk factors for status of HBV-DNA single positive.Conclusion The main cause of serological HBsAg(-)in single HVB-DNA positive specimens were OBI and"window period".The expression patterns of serum markers among HVB-DNA positive donors vary from different areas,and the positive rates of anti-HBs and anti-HBc were relatively higher in Tianjin.ELICA could reduce the risk of missed detection of HBsAg in ELISA,and the risk of HBV-DNA single positive was higher in the group of blood donors born before 1992 and those who donated blood for the first time.