武汉地区无偿献血者戊型肝炎病毒感染状况分析

Hepatitis E virus prevalence among blood donors in Wuhan

目的调查武汉地区无偿献血者戊型肝炎病毒(hepatitis E virus,HEV)感染情况及特征。方法2021年1~12月收集了武汉血液中心无偿献血者血液标本1302份,其中ALT(alanine transaminase)正常的无偿献血者标本1076份,ALT升高的标本226份。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测抗-HEV IgG、抗-HEV IgM和HEV-Ag;采用Real-time PCR对ALT升高的标本和抗-HEV IgM或HEV-Ag阳性的ALT正常标本进行HEV RNA单人份检测。采用χ2检验来评估不同性别、不同年龄和不同ALT水平组的抗-HEV IgG和抗-HEV IgM阳性率的差异。采用单因素和多因素逻辑回归分析HEV IgG血清阳性的潜在危险因素。结果1302份血液标本的总体抗-HEV IgG、抗-HEV IgM和HEV-Ag阳性率分别为16.44%、1.0%和0.08%。ALT正常组抗-HEV阳性率与ALT升高组抗-HEV阳性率无差异(抗-HEV IgG 17.01%vs 13.72%,抗-HEV IgM 0.93%vs 1.33%,均为P>0.05)。ALT升高组的所有标本、抗-HEV IgM阳性和HEV-Ag阳性的合格标本均未检测到HEV RNA。单因素和多因素分析显示,年龄是抗-HEV IgG阳性率的独立风险因素,并且抗-HEV IgG阳性率随着无偿献血者年龄的增加而显著升高,从18~25岁年龄段的5.4%上升至46~60岁年龄段的68.7%。结论武汉地区存在输血传播HEV的风险,且无偿献血者年龄越大,HEV传播风险增加。18~25岁献血者抗-HEV IgG低的流行率,提示该年龄组未来感染HEV风险更高。

Objective To investigate the prevalence and risk factor of hepatitis E virus(HEV)infection among blood donors in Wuhan.Methods A total of 1302 serum samples(including 1076 with normal ALT and 226 with elevated ALT)from blood donors were randomly collected from January to December 2021 in Wuhan Blood Center.Anti-HEV IgG,IgM and HEV antigen(Ag)were examined by enzyme-linked immunosorbent assay(ELISA).The IgM or Ag positive and elevated ALT samples were subjected to real time-PCR to detect HEV RNA.Multivariable logistic regression modeling was used to examine the risk factors associated with HEV prevalence.Results Overall,the positive rates of anti-HEV IgG,IgM,and Ag were 16.44%,1.0%and 0.08%,respectively.However,none of the serum samples were HEV RNA positive.The prevalence of anti-HEV IgG and anti-HEV IgM was similar in samples with increased ALT and normal ALT(IgG 13.72%vs 17.01%,P>0.05;IgM 1.33%vs 0.93%,P>0.05).Multivariate analysis revealed a strong statistical association between age and HEV IgG seroprevalence.The prevalence increased with increasing age,from 5.4%(18~25 years old)to 68.7%(the highest)in blood donors above 46 years(P<0.05).Conclusion HEV showed a seroprevalence among blood donors in Wuhan,some of whom were recent infections,suggesting a threat to the safety of blood transfusions.A low anti-HEV prevalence in young adults(18~25 years)is indicative of a susceptible population and implicates a higher risk of HEV infections in this age group in the future.