福州地区献血者人群隐匿性乙型肝炎病毒感染及其基因型与S区突变的研究  

Study on occult hepatitis B virus infection,genotype of virus and mutation among blood donors in Fuzhou

作　　者：涂东晋[1] 赵亮[1] 林授[1] 林洪铿[1] 沈晓丽[2] 

机构地区：[1]福建省血液中心,福建福州350004 [2]福建医科大学基础医学院

出　　处：《中国输血杂志》2015年第5期523-527,共5页Chinese Journal of Blood Transfusion

基　　金：福建省卫生厅青年科研课题(2012-1-13)

摘　　要：目的探讨福州地区无偿献血者人群隐匿性乙型肝炎病毒感染(OBI)状况及其HBV基因型分布特征与S区氨基酸突变的情况。方法应用血清学方法与核酸检测技术(NAT),对福建省福州市2011年11月-2013年3月的102 866(人)份无偿献血者标本做常规HBs Ag筛查及HBV DNA检测,排除HBV血清学标志物乙肝两对半检测结果阴性标本,确定HBs Ag-HBV DNA+为OBI标本;应用实时荧光定量PCR技术对OBI标本做HBV DNA检测,S区基因采用巢式PCR扩增和序列测定,使用MEGA5.0软件对HBV基因分型和对S区氨基酸做突变分析。结果2011年11月-2013年3月福州地区无偿献血者标本共筛查出75例HBs Ag-HBV DNA+[0.073%(75/102 866)],其中OBI率0.064%(66/102 866);66例OBI标本中,抗-HBc阳性比例为93.94%(62/66),HBV DNA检出率18.18%(12/66),HBV DNA为(13-302)IU/m L,仅1例标本的HBV DNA>200 IU/m L,15.15%(10/66)的OBI标本扩增出S区基因序列,其中B型7例、C型3例;突变分析发现在这10例中有7例HBV S区氨基酸发生突变,而其中又有6例的HBs Ag抗原决定簇基因及周边主要亲水区域(MHR)发生氨基酸突变。结论福州地区无偿献血者人群中存在一定的OBI感染率,其中抗-HBc阳性者比例占多数,OBI感染者的病毒载量低;HBV基因型主要以B型为主,HBV S区尤其是MHR的氨基酸突变可能是造成OBI发生的主要原因之一。Objective To investigate the prevalence of the occult hepatitis B virus infection（ OBI） in blood donors in Fuzhou,the distribution of the viral genotype and the mutation in amino acid sequence in S region of viral genome. Methods A total of 102 866 samples were collected in Fuzhou. All samples were tested by serologic testing of HBs Ag and nucleic acid testing. Then,the HBs Ag- HBV DNA ＋ samples were tested by serologic screening for HBV antigen and antibody. The OBI samples underwent real- time fluorescent quantitative PCR detection and nest-PCR on the S region of viral genome. Lastly,the genotype and the mutation of the viral strains were analyzed based on the sequences. Results 75 in 102 866 donations were HBs Ag- HBV DNA ＋. 66（ 0. 064%） samples were selected as OBI samples. 62 in 66（ 93. 9%） OBI samples were anti-HBc positive. Among the 66 OBI plasma samples tested by real-time fluorescent quantitative PCR,only 12 were detected with HBV DNA. The DNA copies were between 13 to 302 IU / ml,but only one sample of DNA copy was greater than 200 IU / m L. Ten samples could amplify S region sequences with nest-PCR. Seven were B genotypes and 3 were C genotypes. 7 in 10 had mutations in S region of viral genome. There were6 samples in which main mutations occurred at the major hydrophilic region（ MHR） of S antigen. Conclusion The prevalence of OBI in blood donors in Fuzhou was 0. 064%. The majority of OBI samples were anti- HBc positive. The viral loads of OBI were very low. In this study,blood donors had mainly B genotypes in Fuzhou. The mutations at the MHR of S region could be one of the factors for OBI occurrence.

关 键 词：隐匿性乙型肝炎病毒感染 献血者 HBV基因型 基因突变 福州 

分 类 号：R446.1[医药卫生—诊断学] R512.62[医药卫生—临床医学]