HBsAg联合HBVDNA检测用于HBsAg反应性献血者归队评估的可行性  

The role of HBs Ag combined with HBV DNA-ID in reentry of donors deferred because of HBs Ag-reactive

作　　者：邓雪莲[1] 陈辉[1] 王新梅[1] 臧亮[1] 王东[1] 高慧卉[1] 邹亚轩[1] 周璐[1] 李玲[2] 梁晓华[1] 

机构地区：[1]大连市血液中心,辽宁大连116001 [2]中国医学科学院北京协和医学院输血研究所

出　　处：《中国输血杂志》2016年第1期3-8,共6页Chinese Journal of Blood Transfusion

基　　金：卫生部医药卫生科技发展研究中心专项课题(卫技中[2012]12号28-8-3);国家卫生计生委委托项目

摘　　要：目的评估HBs Ag和HBV DNA的指标组合用于HBs Ag反应性献血者归队识别的可靠性。方法以HBs Ag电化学作为第3方检测试剂对核酸无反应性但HBs Ag反应性血液进行复核,筛选出不被其他检测试剂证实的HBs Ag反应性献血者;通过献血者的跟踪检测确定存在的HBV感染者;以HBs Ag联合HBV DNA(单检)作为基本组合,与抗-HBs(定性)、抗-HBs(定量)和抗-HBc搭配形成6个检测指标组合,比较不同组合对已确定的HBV感染的检出能力。结果在173名HBs Ag反应性献血者中确认出7名存在HBV感染;HBs Ag+HBV DNA(单检)对HBs Ag反应性献血者中HBV感染的检出率为0.41/万(0.12/万,0.70/万),在6个检测指标组合中最低,而联合了抗-HBs(定量)和抗-HBs(定量)+抗-HBc的2组检出率最高[1.45/万(0.91/万,1.99/万)]。结论仅以HBs Ag+HBV DNA作为HBs Ag反应性献血者的归队评价的指标并不足以保证血液的安全性,抗-HBs(定量)可能是需要附加的重要指标。Objective To evaluation the impact of HBsAg combined with HBV DNA-ID in reentry of donors deferred because of HBsAg-reactive. Methods As third-party reagent,HBsAg（ ECIA） was adopted to distinguish indetermination from HBsAg-positive donors by retesting samples which were HBsAg ELISA-reactive and HBV DNA-nonreactive. HBV infections in HBsAg-indeterminate donors were identified by follow-up. 6 groups of test index,consisting of HBsAg / HBV DNAID,HBsAg / HBV DNA-ID / anti-HBc,HBsAg / HBV DNA-ID / anti-HBs（ qualified）,HBsAg / HBV DNA-ID / anti-HBs（ quantified）,HBsAg / HBV DNA-ID / anti-HBc / anti-HBs（ qualified） and HBsAg / HBV DNA-ID / anti-HBc / anti-HBs（ quantified）,were compared for detecting HBV infections in indeterminate donors. Results 7 HBV infective cases in 173 HBsAg-indeterminate donors were identified by follow-up. Among 6 groups of test index,HBsAg / HBV DNA-ID occupied the lowest position in HBV infection detection,the detection rate of which was 0. 41 × 10^- 5（ 0. 12 × 10^- 5,0. 70 × 10^- 5）,while HBsAg/HBV DNA-ID / anti-HBs（ quantified） and HBsAg / HBV DNA-ID / anti-HBc / anti-HBs（ quantified） presented the highest detection capability[1. 45 × 10^- 5（ 0. 91 × 10^- 5,1. 99 × 10^- 5） ]. Conclusion There was the obvious insufficient for HBsAg/HBV DNA（ ID） used to evaluate risk of reentry of donors deferred by HBsAg-reactive. Anti-HBs（ quantified） plus to HBsAg / HBV DNA（ ID） could be the best choice for insurance.

关 键 词：献血者归队 核酸检测 HBSAG 确认 联合检测 

分 类 号：R[医药卫生]