核酸检测降低临床输血传播疾病残余风险的研究

目的:分析核酸检测对于降低输血传播疾病残余风险的必要性。方法:对本血液中心2016年3月1日至2016年7月31日5113例无偿献血者标本采用ELISA法进行传染病四项初、复检检测,同时对所有标本进行HBV DNA,HCV RNA,HIV RNA 3项联合核酸检测,并对两种方法阳性的标本进行追踪检测,分析其有无血清学转换,继而确定是否存在感染。结果:在本组研究对象中ELISA阳性88例,阳性率0.17‰,NAT检测阳性9例,阳性率0.02‰,其中HIV RNA阳性4例、HCV RNA阳性2例,HBV DNA阳性3例(ELISA检测阴性),征得献血者同意后对HBV DNA阳性标本中的1例进行追踪检测,发现为隐匿性乙肝感染(OBI)。结论:ELISA检测能够使血液的安全性得到一定的保障,但由于其方法的局限性以及窗口期等原因存在漏检现象,核酸检测可有效弥补这一缺点,降低了输血传播疾病的残余风险。

Objective: to analyze the nucleic acid testing for the necessity of reducing the risk of residual blood transfusion transmitted diseases.Methods: our blood center on March 1, 2016 to July 31, 2016, 5113 cases of specimens of unpaid blood donors by ELISA method for detection of infectious disease at the beginning of the four, the re-inspection, HBV DNA for all samples at the same time, HCV RNA, HIV RNA 3 joint nucleic acid detection, and the two methods of positive specimens for tracking detection, analysis of the presence of seroconversion, which in turn determine the presence of infection.Results: ELISA positive 88 cases in this group of the research object, positive rate 0.17 ‰, NAT 9 cases, detection rate of 0.02 ‰, among them 4 cases were positive for HIV RNA, HCV RNA positive in 2 cases, HBV DNA positive in 3 patients(ELISA test negative), obtained the consent of blood donors for HBV DNA positive specimens, Conclusion: ELISA detection can get a guarantee of the safety of the blood, but due to the limitations of the methods and the window exist leak phenomenon, nucleic acid detection can effectively make up for the shortcomings, to reduce the residual risk of transfusion transmitted disease.