徐州地区无偿献血者人群的乙型肝炎病毒表面抗原的检测及突变分析  

The detection and mutation analysis of HBsAg in unpaid blood donors of Xuzhou city of China

作　　者：裴培培 毕星秀 PEI Pei-pei;BI Xing-xiu(Xuzhou Blood Center,Xuzhou,Jiangsu 221000,China)

机构地区：[1]江苏省徐州市红十字中心血站,江苏徐州221000

出　　处：《中国病毒病杂志》2020年第5期376-378,共3页Chinese Journal of Viral Diseases

摘　　要：目的探讨徐州地区无偿献血者人群的乙型肝炎病毒(hepatitis B virus,HBV)表面抗原(HBsAg)筛查的漏检情况及S区氨基酸突变状况,为HBV检测策略提供依据。方法对采集的2016-2018年徐州地区无偿献血者人群的288986份血液标本进行HBsAg筛查及HBV DNA检测。应用巢式PCR技术对经核酸检测确认的阳性标本进行HBVS区基因扩增、测序及分析。结果徐州地区无偿献血者人群的HBV总阳性率为0.197%(569/288986),酶联免疫吸附测定法(enzyme linked immunosorbent assay,ELISA)检测HBsAg双试剂阳性的阳性率为0.101%(292/288986),HBV DNA确证的阳性率为0.096%(277/288986)。对277例HBV DNA确证阳性标本的140条序列进行HBVS基因测序分析,检测到经典突变位点sE2G(0.71%,1/140)、sT47A(2.14%,3/140)、sC69*(2.14%,3/140)、sL98V(1.43%,2/140)、sK122R(0.71%,1/140)、sI126T(6.43%,9/140)和sW182*(2.14%,3/140)及新突变位点sL87M(4.29%,6/140)、sV106A(5.0%,7/140)、sA166V(2.86%,4/140)和sF179L(5.71%,8/140)。利用3种不同品牌的ELISA HBsAg试剂盒检测发现,突变株HBsAg的最低浓度值相应增高,提示可能发生病毒免疫逃逸。结论徐州地区无偿献血者人群存在HBsAg筛查漏检情况,不同试剂检测HBsAg存在差异,其原因可能是HBVS区尤其是sI126T的氨基酸突变。Objective To study the prevalence of false positive HBsAg detection among blood donors in Xuzhou area and the impact of HBV Sgene mutation on HBsAg detection.Methods A total of 288986samples from 2016to 2018were collected in Xuzhou,Jiangsu province,China.The samples were tested by two different HBsAg ELISA kits.Nest PCR was used to amplify HBVSgene of the samples confirmed by HBV DNA detection and mutation analysis was conducted.Results The total positive rate of HBV was 0.197%(569/288986),the positive rate of HBsAg by two ELISA kits was 0.101%(292/288986),and the positive rate confirmed by HBV NDA detection was 0.096%(277/288986).After the HBVSgene sequences analysis of the 277 HBV DNA positive samples,a total of 140sequences were obtained.Mutations such as sE2G(0.71%,1/140),sT47A(2.14%,3/140),sC69*(2.14%,3/140),sL98V(1.43%,2/140),sK122R(0.71%,1/140),sI126T(6.43%,9/140)and sW182*(2.14%,3/140),and some new mutations,such as sL87M(4.29%,6/140),sV106A(5.0%,7/140),sA166V(2.86%,4/140)and sF179L(5.71%,8/140)were found.To confirm the influence of these mutations on HBsAg detection,the HBsAg of samples were diluted and detected with three different HBsAg ELISA kits.The results showed that three ELISA kits showed different results in these mutations.Conclusions HBsAg is detected to be false negative by ELISA kits.HBVSgene mutation could be one of the reasons.

关 键 词：乙型肝炎病毒 HBSAG检测 病毒突变 S基因 输血传播 

分 类 号：R512.62[医药卫生—内科学]