摘要
目的研究分析嘉兴地区献血人群隐匿性乙肝病毒(OBI)感染血清学及病毒学特征。方法采用常规的ELISA(HBsAg、抗-HCV、抗-HIV、抗-TP)和核酸扩增技术(NAT)对本中心52 698份无偿献血者标本进行联合筛查,对NAT+标本做进一步鉴别检测病毒类型;收集HBs Ag-/HBV-DNA+的标本再另选3种不同的HBs Ag酶免试剂盒定性检测,并选用化学发光对HBsAg和抗-HBs定量检测,同时采用实时荧光PCR(QPCR)进行HBV核酸病毒载量测定;再结合血清学乙肝三系标志物、追踪检测和一般流行病统计学资料(性别、献血次数和年龄)来进一步分析研究OBI的血清学及病毒学相关分布情况。结果共确认47例OBI感染者,OBI流行率为0.89‰(1∶1 121),窗口期(WP)2例(1∶26 349);HBsAg、HBeAg检测结果均为阴性,发现6种OBI血清学模式,抗-HBs定量>100 m IU/m L的标本占27.66%(13/47),抗-HBc+占91.49%(43/47),HBV-DNA核酸定量范围(4.10-1.82)×10~3(IU/m L)(中位数15.83),5例阳性对照HBsAg+/HBV-DNA+病毒载量范围(61.47-1.28)×104(IU/m L)(中位数538.15),两组结果比较,其差异有统计学意义(P<0.05);40岁以上的男性献血者OBI感染率高(P<0.05),多次献血者与首次献血者OBI感染率差异有统计学意义(0.01<P<0.05)。结论 OBI感染者病毒载量低,以抗-HBc+为主要血清学表现形式;NAT可以检出OBI,缩短窗口期,有利于保障临床血液安全。
Objective To research and analyze serological and virological epidemiology charactererization of occult hepatitis B virus infection in Jiaxing volunteer blood donors.Methods 52 698 samples were screened by ELISA （ HBsAg,anti- HCV,anti-HIV, anti-TP） and Nucleic acid amplification technique （NAT）, then NAT positive samples were further identified to detect virus type.HBsAg-/HBV-DNA＋ samples were collected in three different kinds of qualitative HBsAg detection of ELISA kit.The quantitative determination of HBsAg and anti-HBs were used by chemiluminescencemethod.At the same time, real-time fluorescence quantitative PCR （QPCR） was used to measure the viral toad of HBV.Further analysis and study on the serological and virological distribution of OBI combined with five markers of hepatitis B virus （HBV）, with tracing general epidemiological data （sex, age and age）.Results The prevalence rate of OBI was 0. 89%0 （ 1：1 121 ） in all donors with OBI infection, and 2 cases of window period （WP） were found in 52698 donors （ 1 ： 26 349）. The results of HBsAg and HBeAg were negative in 49 HBsAg-/HBV-DNA＋ samples, and 60BI serological profiles were found.Anti-HBs quantitative concentration （ 〉 100 mIU/mL） accounted for 27.66% （ 13/47 ） , while anti-HBc ＋ positive rate was 91.49% （ 43/47 ）. HBV- DNA nucleic acid quantitative ranged from 4. 10 to 1.82× 103（IU/mL） （median of 15.83） , whereas HBsAg＋/HBV-DNA＋ positive viral load was in the range of 61.47 to 1.28× 104（IU/mL） （ median of 538.15） .The difference was significant in viral load between experiment group and control group（P〈0. 05）.Male donors of more than 40 years were higher in prevalence rate of OBI infection （P〈0. 05） , meanwhile there was a significant difference in OBI infection rate between repeated blood donors and first blood donors（0. 01〈P〈0. 05）.Conclusion The viral load was low in OBI infected donors, and anti-HBc＋ was the main manifestation.NAT had the ability to detect OBI, shorten the window period, and contributed to ensure the safety of clinical blood.
出处
《中国输血杂志》
北大核心
2017年第7期780-784,共5页
Chinese Journal of Blood Transfusion
基金
嘉兴市社会发展领域研究与示范应用项目(2016AY23097)
