摘要
目的研究德宏地区HBs Ag检测阴性HBV/HCV/HIV核酸联检反应性献血者的HBV感染特征。方法对2011年6月15日-2014年10月31日筛查献血者中,血清学阴性核酸联检反应性,鉴别HBV DNA阳性和鉴别无反应性的献血者62名,进行追踪和流行病学问卷调查,对已追踪献血者的标本进行HBs Ag、抗-HBs、HBe Ag、抗-HBe、抗-HBc化学发光检测,HBV DNA定性检测和高精度定量检测,对未追踪的献血者,对存留标本做补充试验。依据试验结果及流行病学问卷调查情况,综合分析确定HBV感染率及感染特征。结果 62名献血者中,确定HBV感染48例(77.4%);其中窗口期感染1例(2.08%),一过性感染3例(6.25%),OBI 44例(91.7%)。本次筛查标本中,HBV窗口期、一过性感染率和OBI感染率分别为0.02‰,0.07‰,1.02‰。核酸联检假阳性14例(占22.6%)。结论核酸检测技术对降低输血相关HBV感染风险具有重要作用,但也存在一定的假阳性和假阴性问题,HBs Ag阴性核酸联检初次反应性的献血者,大多为隐匿性感染者,使用多项目重复检测能有效提高其检出率,献血者追踪可确定其真实感染情况。
Objectives To study the characteristics of HBV infection in the blood donors tested negative for HBsAg and reactive for simultaneous detection of HBV/HCy/HIV nucleic acid in Dehong Blood Center. Methods 62 donors were screened as negative for HBsAg and reactive for simultaneous detection of HBV/HCV/HIV nucleic acid to detect the pres- ence of HBV DNA or all three viral genomes by the discriminatory testing in the period from June 15th of 2011 to October 31st of 2014. Follow-up study and epidemiological questionnaire survey were conducted for the 62 donors. The follow-up samples were tested for the presence of HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc by chemiluminescence immunoassay and repeatedly for qualitative and quantitative tes- ting of HBV DNA from the donors available for the follow-up study. Stored samples were used for supplemental testing. HBV infection rate and infection characteristics were analyzed ac- cording to the results of the follow-up sample testing, stored sample testing and questionnaire survey. Results Of the 62 do- nors, 48 were HBV infected donors accounting for 77.4%, including 1 donor with window period infection accounting for 2. 08%, 3 donors with transient infection accounting for 6.25% and 44 donors with OBI （occult HBV infection） accounting for 91.7%. Among the whole blood donors in the study period, the prevalence of HBV window period infection, HBV transi- ent infection and OBI was 0. 02%,,0. 07%o,and 1.02%0, respectively. 14 （22. 6% ） donors were found as false positive for simultaneous detection of HBV/HCV/HIV nucleic acid. Conclusion Nucleic acid testing is an important method for reduc- ing the residual risk of transfusion transmitted HBV. However, false negative and false positive results still existed in nucleic acid testing. Most of the donors screened negative for HBsAg and reactive for simultaneous detection of HBV/HCV/HIV nu- cleic acid were OBI. False negativity can be reduced by multiplex methods and repeat testing. The follow-up study was help- ful to clarify the actual infection condition. OBI is prevalent in the countries and regions with high prevalence of HBV and the blood of OBI donors is risky because of low titer of anti-HBs. Thus, it is very important to improve the sensitivity and speci- ficity of nucleic acid testing, so as to decrease the residual risk of transfusion transmitted HBV.
出处
《中国输血杂志》
CAS
北大核心
2016年第2期173-177,共5页
Chinese Journal of Blood Transfusion
关键词
献血者
乙型肝炎病毒感染
核酸检测
流行病学调查
追踪
blood donors
Hepatitis B virus infection
nucleic acid testing
epidemiological survey
follow-up study
