绵阳地区无偿献血者中HBsAg真实流行情况调查:献血前快检以及献血后筛查确证试验结果联合分析  

Hepatitis B Virusprevalence in Chinese blood donors:HBsAg reactive rates from pre-donation rapid test and post-donation screening test

作　　者：黄梅 文秀琼 曹汝安 高瞻[2] 付萍[2] 王憬惺[2] 刘静[3] 山华 刘鱼[2] 何苗[2] HUANG Mei WEN Xiuqiong CAO Ruan GAO Zhant FU Ping WANG Jmgxmg LIU Jing SHAN Hua LIU Yu HE Miao(Mianyang Red Cross Blood Station, Mianyang 621000, China Institute of blood transfusion, Peking Union Medical College, Chinese Academy of Medical Sciences Johns Hopk Ins University Stanford Hospital.)

机构地区：[1]绵阳红十字中心血站,四川绵阳621000 [2]中国医学科学院北京协和医学院输血研究所 [3]约翰霍普金斯大学医学院 [4]斯坦福医院

出　　处：《中国输血杂志》2017年第5期451-453,共3页Chinese Journal of Blood Transfusion

摘　　要：目的通过对绵阳地区献血前HBsAg快检及献血后血液筛查确证试验结果进行联合分析,更准确的研究献血者中HBV的真实流行情况。方法收集绵阳市中心血站2015年1-8月的献血前HBsAg快检反应阳性样品,并且从征得同意的反应阳性献血者抽取静脉血样进行HBsAg确证中和试验。从血站检验科收集献血后HBs Ag的筛查反应阳性样品进行HBsAg确证中和试验。最后利用献血前和献血后的确证结果估算HBV的流行率。结果2015年1-8月,绵阳59.4%(177/298)的献血前HBsAg快检反应样本成功采集并进行了确证试验,其确证阳性率为95.5%(169/177)。2015年全年献血后59.0%血液筛查反应样本中和试验阳性(249/422)。2015年绵阳市中心血站共有45 424位献血者,其中献血前快检阳性者422人,通过推算献血前和献血后的确证阳性数计算绵阳地区献血者中总的HBV流行率为1.44%。结论献血前HBsAg的快检有效地阻止从HBV感染献血者中采集血液,目前的快检有着较高的特异性。同时,快检漏检的HBV感染献血者也能在献血后的HBsAg筛查中被检测出来。本研究结合献血前HBsAg快检淘汰和献血后HBsAg反应献血者数据估算了绵阳地区献血者中的真实的HBsAg流行率,提供了1个中国献血者的HBV流行率调查新模型。Objective The aim of this study is to perform HBsAg neutralization （NT） on pre-donation rapid HBsAg test reactive samples as well as post-donation screening reactive samples to provide a more accurate estimate of HBV prevalence among Chinese blood donors. Methods Rapid HBsAg test is done on blood collected by finger stick. From June to August 2015, donors with pre-donation HBsAg RT reactive results at Mianyang blood center were asked to give a venous blood sam- ple for HBsAg CT. Samples from consented donors were subjected to HBsAg NT for confirmation of HBV infection. Post-dona- tion HBsAg screening and CT results were collected from blood center database. HBsAg CT positive rates for pre-donation and post-donation HBsAg reactive donors were used for the prevalence estimate. Results From June to August, 59.4 % of all pre-donation HBsAg RT reactive samples were tested by CT with 95.5% CT positive rates in Mianyang. From post-donation screening reactive samples during the same period, 249 out of 422 （59.0%） were NT confirmed positive. In 2015, a total num-ber of 45 424 donors, including 422 HBsAg RT positive donors, attempted to donate whole hlood in Mianyang hh^M center. The estimated overall HBV prevalence in blood donors was 1.44%. Conclusion The HBsAg pre-donation rapid test has been effective in preventing donations to be collected from HBV infected donors. The current rapid test method appears to have high sensitivity. At tile same time, some HBV infected donors escape the rapid test and can be detected by post-donation HBsAg screening. Chinese hlood centers do not routinely perform confirmatolT testing for HBsAg. Our study is one of the first to provide estimate of HBV prevalence among Chinese blood donors by combining cotffirmatoty results from both HBsAg pre- donation deferrals with post-donation HBsAg test reactive donors. Our resnhs and study approach help to improve our understanding of the current risk of HB infection through blood transfusion in China and provide an investigation model for fur

关 键 词：HBSAG 快检 ELISA 确证试验 流行率 

分 类 号：R512.62[医药卫生—内科学] R446[医药卫生—临床医学]