大连地区无偿献血者隐匿性乙型肝炎病毒感染pre-S/S区基因分析  

Analysis of pre-S/S gene in occult hepatitis B virus infection from blood donors in Dalian,China

作　　者：王东[1] 邓雪莲[1] 周璐[1] 方琳琳[2] 宋浏伟[2] 袁权[2] 安万新[1] 

机构地区：[1]大连市血液中心,辽宁大连116001 [2]厦门大学国家传染病诊断试剂与疫苗工程技术研究中心

出　　处：《中国输血杂志》2015年第1期26-31,共6页Chinese Journal of Blood Transfusion

基　　金：大连市科技计划指导性项目(大卫科发[2013]50号);大连市医学重点学科优秀卫生专业技术人才培养资助项目(大卫科发[2013]383号)

摘　　要：目的了解大连地区无偿献血者隐匿性肝炎乙型病毒感染(OBI)的情况和pre-S/S区基因的变异情况。方法对大连市血液中心2010年12月2日-2013年5月31日的无偿献血者血液标本进行常规ELISA(HBs Ag、抗-HCV、抗-HIV和抗-TP)和HIV/HBV/HCV联合NAT筛查,对于单独核酸检测反应性的献血者加以跟踪或回溯,结合乙型肝炎血清学标志物的试验、鉴别试验、病毒定量试验和半巢式PCR来确定OBI,同时对OBI的pre-S/S区基因序列与对照组(HBs Ag+序列,Genbank)做比对分析。结果共筛查158 232份血液标本,确定了其中的69份OBI,流行率为1∶2 293(69/158 232)。41例OBI获得pre-S/S区基因序列:B型6例、C型34例、D型1例;与对照组相比,OBI在S区的氨基酸序列的变异明显(PB=0.013;PC=0.003),主要变异位点为B型的V14G/A、Y161F/S、V168A、P217L和C型的E2G/A/V、T118R/K/A/M、P127T/L/H/S、E164D/G、L175S、S174N。结论大连地区献血者OBI在HBV基因组S区的氨基酸序列存在多个位点的变异,这些变异与OBI的产生存在某种关系,且这种关系受基因型的影响。Objective To understand the prevalence of occult infection of hepatitis B virus （OBI） and the mutations of pre-S/S gene from blood donors in Dalian. Methods From December 2nd , 2010 to May 31st , 2013, samples from blood do- nors in Dalian Blood Center were screened with enzyme-linked immunosorbent assay （ELISA） for HBsAg, anti-HCV, anti- HIV and anti-TP and triplex nucleic acid detection （NAT） for HIV RNA, HBV DNA and HCV RNA. A follow-up was con- ducted on donors who were tested negative by ELISA but reactive by NAT. OBI was determined by testing the specimens from the follow-up or archive with serological markers of hepatitis B virus, identification examinations, quantitative and semi-nes- ted PCR. The seq/lences of pre-S/S gene of OBIs and the control group were analyzed （ HBsAg ＋ , Genbank）. Results 158 232 blood samples were screened, 69 of which were OBls. The prevalence rate of OBIs was 1：2 293 （69/158 232）. The pre-S/S gene sequences were analyzed in forty-one cases of OBI： 6 were type B, 34 were type C, and 1 was type D. Comparing the amino acid sequences between the experimental and control groups, there were statistical significance in the S region of OBI （PB = 0. 013; Pc = 0. 003）. The main mutation sites of amino acids for type B were V14G/A, YI61F/S, V168A and P217L while for type C were E2G/A/V, TIlSR/K/A /M, P127T/L/H/S, E164D/G, L175S and S174N. Conclusion There were multiple mutation loci on the amino acid sequence of OBI from blood donors in Dalian. A particular relationship existed between these mutations in S region from HBV genome and the mechanism of OBI, which was influenced by genotypes.

关 键 词：隐匿性乙型肝炎病毒感染(OBI) pre-S/S区基因 氨基酸序列变异 乙型肝炎病毒 无偿献血者 大连 

分 类 号：R446.112[医药卫生—诊断学] R512.62[医药卫生—临床医学]