洛阳地区无偿献血人群中核酸检测及分析

Analysis of nucleic acid detection and follow-up of voluntary blood donors in Luoyang area

目的:了解洛阳地区无偿献血人群中核酸检测及追踪情况。方法:对2012-03-11—2017-12-31参与无偿献血的献血者标本进行2次酶联免疫法和1次核酸检测,并对ELISA检测无反应性、核酸检测有反应性的献血者进行跟踪检测,定期采集其血样进行血液筛查和补充试验,以便确定是否为"窗口期"。结果:163 436份无偿献血者血液标本中检出酶联免疫法无反应性核酸联检有反应性标本310份,进一步对这310份标本进行病毒种类的鉴别,最后鉴别出乙型肝炎病毒(HBV DNA)阳性119份,人类免疫缺陷病毒(HIV RNA)阳性1份,丙型肝炎病毒(HCV RNA)阳性0份。最终随访到19例献血者(鉴别结果为HBV DNA阳性的献血者7例,经确认有5例OBI,2例HBV"窗口期";鉴别结果为阴性的献血者11例,经确认有1例HBV"窗口期";鉴别结果为HIV RNA阳性的献血者1例确认结果是HIV"窗口期")。结论:核酸检测确实能够最大限度地减少方法学上引起的血液安全风险,最大程度地提升血液安全,这对保证用血者健康具有重要意义。

Objective::To understand the nucleic acid detection and follow-up of voluntary blood donors in Luoyang area. Method:From March 11,2012 to December 31,2017,two times of Enzyme-linked immunosorbent assay(ELISA)and one nucleic acid test were performed on blood specimens from voluntary blood donors who came to our blood station.The blood donors whose blood specimens did not exhibit reactivity in ELISA,but exhibited reactivity in nucleic acid detection were followed up;and their blood specimens were collected regularly for blood screening and supplementary tests in order to determine whether they were in a 'window period'. Result:Totally 310 of 163 436 blood specimens from donors were found to exhibit no reactivity in ELISA,but exhibit reactivity in nucleic acid detection.The 310 specimens were further identified for virus types,and finally 119 HBV DNA positive,1 HIV RNA positive and 0 HCV RNA positive were identified.Finally,19 blood donors in them were followed up successfully.In 7 blood donors with positive HBV DNA,5 cases of occult HBV infection(OBI)and 2 cases of HBV ' window period' were confirmed.In 11 blood donors with negative HBV DNA,1 case of HBV ' window period' was confirmed.The only donor with positive HIV RNA was confirmed to be HIV 'window period'.Conclusion:Nucleic acid detection can minimize the risk of blood caused by methodology and improve blood safety to the greatest extent,which is of great significance for ensuring the health of blood recipients.