HBsAg、抗-HCV、抗-HIV酶免阴性及单试剂反应性献血者核酸检测结果分析  

Analysis of Nucleic Acid Tests in HBsAg,Anti-HCV,Anti-HIV ELISA Negative or Single Reagent Reactive Blood Donors

作　　者：严凤好[1] 钟展华 李雪群 万小春[1] 

机构地区：[1]广东省惠州市中心血站,516000

出　　处：《临床输血与检验》2017年第4期379-381,385,共4页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：惠州市科技计划项目资助(项目编号:2015Y125)

摘　　要：目的通过对HBsAg、抗-HCV、抗-HIV酶免结果双阴性及单试剂反应性献血者进行核酸检测(NAT),分析两种检测方法的结果差异和鉴别试验的反应性项目,为假反应性献血者的归队提供理论依据。方法分别用两种酶免试剂对献血者血液进行HBsAg、抗-HCV、抗-HIV血清学检测,对酶免阴性及单试剂反应性标本8人份混样进行HBV、HCV、HIV三联核酸定性检测,对NAT呈反应性的标本进行鉴别试验确定反应性的具体标本。结果 31 065份血液标本中酶免双试剂阴性30254份,单试剂反应性241份,其中进口试剂180份,国产试剂61份,主要集中在HCV和HIV进口试剂,两者差异有统计学意义;进行8人份混样NAT检测共有54份呈反应性,包括46份HBV、3份HCV、5份HIV。拆分鉴别实验检出39份HBV,其中ELISA阴性标本鉴别出37份阳性,单试剂反应标本中鉴别出2份,未拆分出HCV、HIV阳性标本,总拆分阳性率为72.2%。结论酶免单试剂反应性结果的假阳性率较高,核酸检测能提高对病毒的检测能力,有效降低经输血途径传播病毒的风险,选择两者互补的检测模式,对酶免单试剂反应性献血者进行追踪随访和复查,可为假反应性献血者的归队提供理论支撑,有利于献血者的召回。Objective Nucleic acid tests were performed in the blood donors and compared with the Results of ELISA double negative and single reagent reactive in HBsAg,Anti-HCV and Anti-HIV so as to provide a basis for distinguishing the false positive blood donors. Methods Two ELISA reagents were used to detect seral HBsAg,HCV and HIV in the donors,and 8 specimens of ELISA negative and single reagent positive samples were subjected to DNAs detections. All DNAs positive samples were identified. Results In 31 065 blood samples,30 254 cases were found to be negative with double ELISA,and 241 cases were positive with single reagent examination,among them 180 cases were detected with imported kits and 61 with domestic reagents. A significant difference was seen in different reagents. DNAs detection showed 54 positive samples including 46 HBV,3 HCV,and 5 HIV. Identification tests revealed 39 positive HBV,among them 37 and 2 cases were found from ELISA negative and single reagent positive samples,respectively. Neither HCV nor HIV was discovered and total positive rate was 72.2%.Conclusion ELISA single reagent reactive result gives rise to a high false positivity while DNAs examination may improve the efficacy of virus diagnosis. Complementary examinations are recommended so as to induce the risk of blood transfusion of infectious diseases.

关 键 词：单试剂反应性 核酸检测 鉴别实验 

分 类 号：R446.61[医药卫生—诊断学] R392.11[医药卫生—临床医学]