深圳市无偿献血者隐匿性HBV感染发展预后以及性传播的研究  

Study on progression and sexual transmission of occult hepatitis B virus infection from blood donors in Shenzhen

作　　者：郑欣[1] 吴桂丹 杜鹏[1] 许晓绚[1] 熊文[1] 

机构地区：[1]深圳市血液中心,广东深圳518035

出　　处：《中国输血杂志》2015年第6期671-675,共5页Chinese Journal of Blood Transfusion

基　　金：深圳市科技计划项目(201302153)

摘　　要：目的研究本地区无偿献血者隐匿性HBV感染(OBI)发展预后以及性传播的可能。方法追踪随访25名来自2010-2012年确认为OBI的无偿献血者及其配偶,采用化学发光方法检测HBs Ag,常规核酸检测方法(NAT)及Nested-PCR方法扩增BCP/PC、S基因确认HBV DNA的存在;实时荧光定量检测方法(QPCR)定量乙肝病毒载量。结果从25名OBI献血者,成功追踪回访15名及6/15名献血者配偶,15名OBI献血者男女比例为8∶7,病毒载量范围在<(10-121.8)IU/m L(中位数14.3 IU/m L),9/15例为抗-HBc阳性。在2-4年后的随访结果,15名OBI献血者有4名(26.7%)转为显性HBV感染(HBs Ag+/HBV DNA+),7名(46.6%)献血者HBV转阴(HBs Ag-/HBV DNA-),4名(26.7%)仍呈OBI持续感染状态(HBs Ag-/HBV DNA+)。OBI转为HBV的献血者的病毒载量显著高于原来OBI感染状态(P<0.05),而仍维持OBI感染献血者的病毒载量与2-4年前相比没有统计学差异(P>0.05)。6名OBI献血者的配偶,均为没有感染HBV(HBs Ag-/HBV DNA-)。结论感染OBI献血者存在自然清除病毒及转为显性HBV感染的发展预后,HBV感染者的起源是否与OBI有关,有待进一步探索。Objective To study the progression of occult hepatitis B virus infection （OBI） and the possibility of sexual transmission from blood donors in Shenzhen. Methods A total of 25 donors diagnosed as OBI and their spouses were followed up from 2010 to 2012. Their blood samples were tested for HBsAg using chemiluminescence method. The presence of HBV DNA was identified by amplifying BCP/PC and S region by nested-PCR. For those samples positive for nucleic acids, QPCR was used to quantify viral load. Results Among 25 OBI donors, 15 OBI donors and 6 of their spouses were success- fully traced. In those 15 OBI patients, there were 8 males and 7 females. Their HBV viral loads rmlged from undetectable （ ~ 10 IU/mL） to 121.8 IU/mL （median 14. 3 IU/mL）. 9 of 15 OBIs were anti-HBc ＋. After 2 to 4 years, 4 of 15 （26. 7% ） OBIs turned into apparent HBV infection （HBsAg ＋/HBV DNA ＋ ）, 7 （46. 6% ） had HBV DNA spontaneously cleared without treatment, and 4 （26. 7% ） remained OBI patients. Viral loads in the OBI-HBV infection group was significantly higher than those previously infected with OBI （P 〈 0. 05）. Correspondingly, viral loads in those 4 remained OBI patients did not change much （P 〉 0. 05 ）. M1 of 6 spouses mentioned above did not get infected with HBV. Conclusion According to the study, OBI donors could be spontaneously cured without any treatment or developed into apparent HBV infection. Further study should be conducted to investigate whether apparent HBV infection was originated from OBI infection.

关 键 词：献血者 隐匿性乙型肝炎病毒感染 追踪 预后 性传播 

分 类 号：R512.62[医药卫生—内科学] R193.3[医药卫生—临床医学]