计划免疫前后出生的献血者HBV DNA阳性状况及其HBV感染的血清学和分子病毒学特征分析  

Serological and molecular characterization of hepatitis B virus infection in blood donors before and after the universal HBV vaccination program

作　　者：叶贤林[1,2] 李懿 李彤[1] 杨红[1] 刘衡[1] 邬林枫[1] 许晓绚[1] 

机构地区：[1]深圳市血液中心,广东深圳518035 [2]大连医科大学检验系

出　　处：《中国输血杂志》2017年第10期1138-1142,共5页Chinese Journal of Blood Transfusion

基　　金：深圳市卫生计生系统科研项目(SZGW2017018)

摘　　要：目的了解深圳市在计划免疫前后出生的无偿献血者HBV感染情况,分析其血清学和分子生物学特征。方法将本中心2016年2-6月收集的26 320人(份)无偿献血者标本,以1992年为界分为计划免疫前出生组组:19 898人(份),年龄18-<24岁;计划免疫后出生组:6 422人(份),24-55岁。分别将每组再分为HBs Ag(+)/HBV DNA(+)、HBs Ag(+)/HBV DNA(-)、HBs Ag(-)/HBV DNA(+)和HBs Ag(-)/HBV DNA可疑(NAT初筛阳性、鉴定试验阴性)4种类型,做"乙肝两对半"检测与HBV DNA小容量和大容量提取,采用巢氏PCR方法扩增BCP/PC和S区基因序列,并对所得序列做基因型分析,同时采用实时荧光定量PCR检测(q PCR)和分析。结果本组26 320(人)份献血者标本,通过酶免方法初筛检出242例HBs Ag不合格标本,经NAT、巢氏-PCR和q PCR检测HBV DNA阳性率为0.741%(195/26 320),其中195名HBV阳性者里有164(130+34)人为初次献血者。计划免疫前后出生2组中初次献血者的HBV DNA阳性率分别为1.309%(130/9 929)vs 0.707%(34/4 810)(P<0.05);隐匿性乙肝感染(OBI)阳性率分别为0.256%(51/19 898)vs 0.093%(6/6 422)(P<0.05)。在可分型的120例标本中,HBV基因型B型95例、C型25例,2种基因型在2组间(74/19 vs 21/6)的分布无明显差异(P>0.05)。结论乙肝疫苗的接种明显降低了献血人群HBV感染的风险,有益于输血安全保障的提高。Objective To evaluate hepatitis B virus（ HBV） infection status among the blood donors born before and after the 1992 universal HBV vaccination program in Shenzhen,and to be characterized by serological and molecular analyses.Methods A total of 26 320 blood samples were collected in Shenzhen Blood Center archiving from Feb 2016 to Jun 2016.The samples fell into two categories,where 19 898 donors,aged 24-55 y were assigned to the pre-program group while the rest 6 422 donations from 18-〈 24 y donors were considered post-program samples. Anther four sub-segments were assigned based on HBs Ag,anti-HBs,HBe Ag,anti-HBe and anti-HBc antibody tests yielding the（ HBs Ag（ ＋）/HBV DNA（ ＋）,HBs Ag（ ＋）/HBV DNA（-）,HBs Ag（-）/HBV DNA（ ＋） and HBs Ag（-）/HBV DNA（ ＋/-） groups. Nested PCR with high volume extraction were performed to amplify sequences in the viral BCP/PC and S regions. With the data above,HBV genotype and virus loads were analyzed. Results A total of 26 320 samples of blood donors were collected with 242 cases of unqualified samples screened out according to the HBs Ag test,of which,195 samples were confirmed HBV DNA positive,yielding a positive rate of 0. 741%（ 195/26 320）. The positive rates of HBV DNA were 1. 309%（ 130/9 929） vs 0. 707%（ 34/4810） respectively for the first time blood donors before and after the universal HBV vaccination program,suggesting a significant difference between the two groups（ P〈0. 05）. The positive rates of occult hepatitis B virus infection（ OBI） in the blood donors born after the universal HBV vaccination program was 0. 093%（ 6/6 422）,which is significantly lower than that of the pre-program group at 0. 256%（ 51/19 898）（ P〈0. 05）. 95/120 samples are genotype B while 25/120 are genotype C. There is no significant difference in the distribution of genotype born before（ B/C： 74/19） and after（ B/C： 21/6） the vaccination program（ P〉0. 05）. Conclusion The universal HBV vaccination program s

关 键 词：乙型肝炎病毒 计划免疫 献血者 乙肝两对半 HBV DNA 隐匿性乙型肝炎 

分 类 号：R446.112[医药卫生—诊断学] Q523.3[医药卫生—临床医学]