HBsAg阴性HBV DNA阳性献血者HBV感染类型的相关研究  

Study on HBV infection types of blood donors with negative ELISA and positive HBV DNA

作　　者：陈慧[1] 孙国栋[1] 张丽[1] 张毓[1] 李丽[1] 张玉兰 CHEN Hui;SUN Guo-dong;ZHANG Li;ZHANG Yu;LI Li;ZHANG Yu-lan(Handan Central Blood Station,Hebei 056001,China)

机构地区：[1]邯郸市中心血站,河北056001

出　　处：《医学动物防制》2021年第8期758-760,共3页Journal of Medical Pest Control

基　　金：河北省医学科学研究课题计划(20191819)。

摘　　要：目的分析化学发光法和PCR技术检测无偿献血者乙肝表面抗原(HBsAg)阴性HBV DNA阳性样本的感染类型。方法选取邯郸市中心血站2019年1-6月留取的HBsAg阴性或单试剂阳性合并华益美核酸定性检测(nucleic acid qualitative detection,NAT)阳性的献血者样本39份,进行罗氏核酸定性、化学发光(Chemiluminescence analysis,CLIA)及核酸定量补充实验,并对实验结果进行分析。结果在53489份献血者样本中,经ELISA初筛检测后,去除双试剂HBsAg阳性20份之后,双试剂HBsAg阴性和单试剂HBsAg阳性的共计53469份(占比99.96%)样本进入核酸检测流程,得到华益美检测HBV DNA阳性39份。其中含有乙肝核心抗体(HBcAb)的血清学模式为29份,占比74.36%,核酸定量结果均小于200 IU/ml,为隐匿性感染;仅乙肝表面抗体(HBsAb)阳性的血清学模式有2份,核酸定量结果均小于200 IU/ml为携带HBsAb隐匿性HBV感染的特殊形式;全阴的血清学模式有8份,成功追踪4份,Z1/Z2和Z4均发生血清学指标转阳,判定为窗口期感染,Z3样本HBsAb转阳核酸转阴,提示为窗口期感染转为急性感染恢复期。结论PCR技术在保障血液安全上突显了较好的检测效能,检出的NAT阳性样本大多是OBI和窗口期感染。Objective To analyze the infection types of HBV DNA positive samples with negative hepatitis B surface antigen(HBsAg)in voluntary blood donors detected by chemiluminescence method and PCR technology.Methods A total of 39 blood donor samples with HBsAg negative or single reagent positive combined with nucleic acid qualitative detection(NAT)positive and collected from January 2019 to June 2019 in Handan Central Blood Station were selected for roche nucleic acid qualitative,Chemiluminescence analysis(CLIA)and nucleic acid quantitative supplement experiments,and the experimental results were analyzed.Results Among the 53489 blood donor samples,after the preliminary screening test by ELISA,and the removal of 20 copies of double-reagent HBsAg positive,a total of 53469 double-reagent HBsAg negative samples and single-reagent HBsAg positive samples(accounting for 99.96%)were put into the nucleic acid detection process,and 39 copies of HBV DNA positive detected by Huayimei were obtained.Among them,29 cases(74.36%)were serological models containing HBcAb,and the quantitative results of nucleic acid were all less than 200 IU/ml,indicating occult infection.Only 2 cases were positive for HBsAb,and the quantitative results of nucleic acid were both less than 200 IU/ml,which was a special form of occult HBV infection carrying HBsAb.There were 8 cases of the serological pattern of total negative,and 4 samples were successfully followed up.Both Z1/Z2 and Z4 had seroconversion to positive,which was determined as window period infection,and Z3 sample HBsAb turned to positive and nucleic acid turned to negative,indicating that window period infection turned to acute infection in the recovery period.Conclusion PCR technology has shown a better detection efficiency in ensuring blood safety.Most NAT positive samples detected were OBI and window period infection.

关 键 词：核酸检测 献血者 HBV感染类型 乙肝表面抗原 ELISA 

分 类 号：R373.21[医药卫生—病原生物学]