摘要
目的分析一例无偿献血者乙型肝炎病毒(hepatitis B virus,HBV)DNA间歇性检出的血清学特征及其S基因测序情况,为正确解释间歇性检出献血者HBVDNA、更好的保证血液安全提供依据。方法收集HBV DNA呈间歇性检出的献血者两次献血标本,使用酶联免疫吸附试验(enzyme-linked immunosorbent assays,ELISA)双试剂检测HBV表面抗原(HBsAg),血筛核酸检测(nucleic acid testing,NAT)筛查HBV DNA。使用电化学发光法进行乙肝五项检测。使用巢式PCR扩增HBV S基因并进行基因测序和分析。结果针对两次标本,ELISA双试剂检测HBsAg均为阴性;NAT结果一次为无反应性,一次为反应性(Ct值为40.52);乙肝五项结果显示HBV e抗体(anti-HBe)、HBV核心抗体(anti-HBc)均为阳性;该献血者两次标本经扩增测序均得到相同的S基因序列,分型为HBV基因型C;与S基因同基因型参考序列比对未发现基因突变。结论该献血者存在隐匿性HBV感染(occult hepatitis B infection,OBI),且表现为常规血筛核酸检测试剂间歇性检出的情况,极易发生HBV漏检,严重影响输血安全。灵敏度高的血筛检测试剂和方法对输血安全至关重要。
Objective The serological characteristics and S gene sequencing of intermittent detection of hepatitis B virus(HBV)DNA from an unpaid blood donor were analyzed to provide a basis for correct interpretation of intermittent detection of HBV DNA from blood donors and better guarantee of blood safety.Methods The samples of blood donors with intermittent detection of HBV DNA were collected for two blood donations.ELISA was used to detect HBsAg and NAT screening for HBV DNA.Electrochemical luminescence method was used to detect five items of hepatitis B.Nested PCR was used to amplify the HBV S gene,and gene sequencing was performed.Genotype and mutation were compared and analyzed.Results HBsAg was negative in both samples by ELISA.NAT result were non-reactive once and reactive once.Hepatitis B e antibody(Anti-HBe)and hepatitis B core antibody(Anti-HBc)were positive.The same S gene sequence was obtained from two samples of the donor by amplification and sequencing,and the genotype was HBV genotype C.No mutation was found in the reference sequence comparison with S gene.Conclusions The donor has occult HBV infection(OBI),which is manifested as intermittent detection by routine screening nucleic acid detection reagent,which is easy to miss HBV detection and seriously affects the safety of transfusion.Sensitive screening reagents and method are very important for the safety of blood transfusion.
作者
刘超
孙可望
王皓
黄象艳
Liu Chao;Sun Kewang;Wang Hao;Huang Xiangyan(Department of Transfusion Medicine,the 960th Hospital of the People’s Liberation Army(PLA)Joint Logistics Support Force(Ji’nan Blood Center of the PLA),Jinan 250031,China;Second Clinical College of Shandong University of Traditional Chinese Medicine,Jinan 250031,China;School of Medical Laboratory,Weifang Medical College,Weifang 261041,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2023年第4期414-417,共4页
Chinese Journal of Experimental and Clinical Virology
基金
山东省自然科学基金(ZR2020MH325)。
