HBsAg阴性、HBV DNA阳性献血者病毒感染特征研究  

Characteristic of HBsAg- with HBV DNA+ in Blood Donors

作　　者：伍晓菲[1] 刘晓颖[1] 张博[1] 莫琴[1] 黄宇闻[1] 贾尧[1] 郑岚[1] 谢云峥[1] 王迅[1] 

机构地区：[1]上海市血液中心,200051

出　　处：《临床输血与检验》2014年第3期232-236,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：上海市卫生和计划生育委员会基金(No.20134099);输血医学上海市公共卫生重点学科建设项目(No.12GWZX0201);公共卫生优秀学科带头人培养计划(No.GWDTR201224)资助

摘　　要：目的了解上海地区献血人群中血清HBsAg阴性、HBV DNA阳性感染的流行率、病毒血清学和分子生物学特点。方法选取HBsAg阴性、核酸筛查确认为HBV DNA阳性的献血者血清标本,采用酶联免疫法(ELISA)检测病毒血清标志物抗-HBc和抗-HBs;PCR扩增HBV S区基因片段,对扩增后的产物进行测序分析后,将产物序列与Genbank中HBV序列进行Blast比对,获得标本HBV毒株的基因型;采用DNAMAN软件进行蛋白表达分析,确定标本毒株的血清型,并与Genbank中野生型HBV序列进行比较,获得S区基因编码蛋白突变情况。结果上海地区HBsAg阴性献血人群HBV DNA阳性感染率约为0.045%。18例HBsAg阴性、HBV DNA阳性标本血清病毒载量均低于200IU/ml,且大部分低于20IU/ml;其中14例(77.8%)病毒血清标志物为抗-HBc和/或抗-HBs阳性。18例样本全部为B和C基因型,主要为adw和adr血清型。14例血清抗-HBc和/或抗-HBs阳性样本中,13例样本发生了S蛋白氨基酸突变,其中8例B基因型较多发生Q101K/H、M103T/I、F134L、D144A突变,5例C基因型较多发生S114T/A、T118K/R、K141T、S143T突变;4例血清阴性样本中,均未发生S区蛋白位点突变。结论上海地区献血者存在HBsAg阴性、HBV DNA阳性感染者,其血清病毒载量低,感染病毒全部为B和C基因型,主要为adw和adr血清型;其中大部分为隐匿性HBV感染,少数可能为窗口期感染;隐匿性HBV感染病毒多发生S蛋白氨基酸位点突变。Objective To investigate the prevalence and characteristics of HBsAg- with HBV DNA＋infection in blood donors in Shanghai.Methods Samples were collected from HBsAg negative/HBV DNA positive blood donors.Enzyme link immunosorbent assay（ELISA）was used to detect serum anti-HBc and anti-HBs.HBV surface antigen region（S）fragments were amplified and sequenced.HBV genotypes were determined by blasting the S nucleotide sequences in GenBank.Amino acid sequences were deduced according to the open-reading frames by DNAMAN software,from which HBsAg serologic subtypes were predicted.S protein mutations were analyzed by comparision with wild-type HBV sequence in GenBank database.Results The prevalence of HBV DNA＋in HBsAg-blood donors in Shanghai was 0.045%.Viral loads in all 18 donors were less than 200 IU/ml and most of them even were less than 20IU/ml.Fourteen donors（77.8%）were reactive to anti-HBc and/or anti-HBs,in which 3donors had weak level of anti-HBs protection（100IU/L）.All these donors were either B or C genotypes and most were adw and adr subtypes.Thirteen with anti-HBc and/or anti-HBs reaction had the S protein mutations,in which 8were genotype B with a higher incidence of Q101K/H,M103T/I,F134L,D144Amutation and 5were genotype C with S114T/A,T118K/R,K141T,S143T mutation.Four donors with negative anti-HBc and anti-HBs did not show S protein mutation.Conclusion There was still some HBV DNA positive in HBsAgnegative donations.Further studies on these HBsAg- but DNA＋ donations showed that the viral loads were remarkably low,the genotypes were B and C,and the antigenic subtypes were adw and adr.Most of these donors had latent HBV infections,except for a small number of window period infections.S protein mutations occurred in most of OBI strains.

关 键 词：献血者 乙型肝炎病毒 隐匿性HBV感染 表面蛋白突变 

分 类 号：R193.2[医药卫生—卫生事业管理] R512.62[医药卫生—公共卫生与预防医学]