摘要
目的分析邯郸地区无偿献血者隐匿性乙肝(OBI)的血清学分布特征。方法选取邯郸市中心血站2017年3月1日~12月31日、采用两种ELISA试剂进行HBsAg检测的无偿献血者血液标本75984例,用常规HBsAg单试剂阳性标本和阴性标本进行核酸(定性)检测,将得到的核酸检测为HBVDNA反应性标本,采用化学发光“两对半”和核酸定量检测,结合检测结果和献血者统计资料进行关联分析。结果得到HBsAg–/HBVDNA+/HBcAb+的样本26例,可能为OBI标本,其中HBsAg–/HBsAb+/HBcAb+及HBsAg–/HBsAb–/HBcAb+为OBI的主要血清型模式,这两种血清型各占总数的30.8%和50.0%。HBsAb>100IU/L标本占总例数的11.5%(3/26),HBsAb为(20~160)IU/L的例数为6例,占总例数的23.1%(6/26)。梯度稀释HBVDNA标准品的浓度(3.15IU/mL、4.2IU/mL、6.3IU/mL、8.4IU/mL)的核酸检测对应CT值依次为41.14、37.45、36.23、35.04。OBI感染率在男性和女性性别上的差异无统计学意义,在年龄分布上,随着岁数增大而呈现升高趋势。结论增加核酸检测会降低单纯采用两遍ELISA法检测HBsAg造成的输血感染风险,特别是对于OBI的检出,提高输血安全。鼓励抗-HBs滴度较低的健康献血人群适时注射乙肝疫苗,降低乙型肝炎的输血传染风险。
Objective To research and analyze the serological characterization of occult hepatitis B virus infection in volunteer blood donors in Handan.Methods From March 1,2017 to December 31,2017,75,984 samples were screened by two ELISA reagents.The normal HBsAg single reagent positive specimens and negative specimens were used to undergo qualitative nucleic acid test.Then HBV DNA positive specimen were further determined by qualitative nucleic acid test and Chemical luminescence "double half" test,the correlation between combined two-method DNAtest resultsand blood donor statistics information was analysed.Results 26 OBI samples were obtained for HBsAg-/HBV DNA^+/HBcAb^+,Among them,HBsAg^-/HBsAb^+/HBcAb^+and HBsAg^-/HBsAb-~/HBcAb^+ are the main serotypes of OBI,Each of these serotypes accounted for 30.8 % and 50.0 % respectively.The number of HBsAb>100 IU/L samples accounted for 11.5 % of the total number of cases(3/26),and the number of HBsAb(20-160) IU/L was 6 cases,accounting for 23.1 % of the total number of cases(6/26).The concentration of the gradient dilution HBV DNA standard(3.15 IU/mL,4.2 IU/mL IU/mL,6.3 IU/mL,8.4 IU/mL) corresponds to the CT values of 41.14,37.45,36.23,and 35.04,respectively.There was no statistically significant difference between men and women in the rate of OBI infection.In terms of age distribution,there was an increasing trend with age.Conclusion Adoption of nucleic acid detection would reduce the risk of blood transfusion infection caused by the double ELISA method,especially for the detection of OBI,and improve the safety of blood transfusion.Encouragement of healthy blood donors with low anti-HBs titration to timely injection of hepatitis B vaccine would reduce the risk of blood transfusion infection of hepatitis B.
作者
张毓
孙国栋
张丽
徐晓艳
ZHANG Yu;SUN Guo-dong;ZHANG Li(The Blood Center Of Handan,Handan 056001)
出处
《临床输血与检验》
CAS
2019年第5期480-485,共6页
Journal of Clinical Transfusion and Laboratory Medicine
基金
河北省卫生健康委员会基金项目（No.20191820）资助
关键词
隐匿性乙型肝炎
核酸检测
献血人群
血清学分布
Occult hepatitis B virus
Nucleic acid test
Blood donors
Serological distribution
