广州地区HBV DNA阳性献血者感染状态及分子流行病学研究  

Infection status and molecular epidemiology of HBV DNA positive blood donors in Guangzhou city of China

作　　者：王敏[1] 戎霞[1] 许茹[1] 廖峭[1] 黄杰庭[1] 单振刚[1] 王淏[1] 钟惠珊 付涌水[1] WANG Min;RONG Xia;XU Ru;LIAO Qiao;HUANG Jie-ting;SHAN Zhen-gang;WANG Hao;ZHONG Hui-shan;FU Yong-shui(Institute of Clinical Blood Transfusion of Guangzhou Blood Center,KeyLaboratory of Blood Safetyin Guangzhou,Guangzhou,Guangdong 510095,China)

机构地区：[1]广州血液中心临床输血研究所广州市血液安全重点实验室,广东广州510095

出　　处：《中国病毒病杂志》2021年第4期255-260,共6页Chinese Journal of Viral Diseases

基　　金：国家自然科学基金资助项目(32000666);广东省医学科学技术研究基金项目(B2019076);广州市科技计划项目(202002030192);广州市医学重点学科建设项目。

摘　　要：目的探讨广州无偿献血人群核酸检测(nucleic acid test,NAT)反应标本中乙型肝炎病毒(hepatitis B virus,HBV)DNA鉴别阳性标本的感染状态以及分子流行病学情况。方法对2015年4月—2017年2月广州血液中心296605份献血者血液样本进行常规酶联免疫吸附实验(enzyme linked immunosorbent assay,ELISA)和转录介导扩增技术(transcription mediated amplification,TMA)的三联核酸(triple NAT,tNAT)筛查。对单tNAT阳性、ELISA阴性且样本充足的1303份标本进行HBV鉴别实验,阳性标本采用荧光定量聚合酶链式反应(fluorescence quantitative polymerase chain reaction,Q-PCR)和巢式聚合酶链式反应(nested polymerase chain reaction,N-PCR)检测并对Pre-S/S、BCP/PC基因进行扩增,并用HBV DNA阳性样本进行电化学发光免疫(electrochemiluminescence immunoassay,ECLIA)测定血清学标志物。结果HBV DNA阳性标本检出381份(29.24%),随机选取187份进行Q-PCR检测和N-PCR扩增,其中44份(23.53%)为病毒载量阴性标本,143份(76.47%)为病毒载量阳性标本。另外,检测到Pre-S/S基因139份,BCP/PC基因128份。测定174份HBV DNA阳性标本,其中隐匿性HBV感染(occult HBV infection,OBI)148份(85.06%),窗口期3份(1.72%),清除7份(4.02%),未分类16份(9.20%)。通过序列对比进行基因分型,其中93份(66.91%)为HBV-B基因型,46份(33.09%)为HBV-C基因型。结论广州地区HBV DNA鉴别阳性献血者中主要流行HBV-B基因型。tNAT反应无偿献血者中存在HBV感染者,且OBI感染者所占比例远大于窗口期感染者所占比例,因此,排除单tNAT反应献血者对预防经输血传播HBV有重要意义。Objective To study the infection status and molecular epidemiology of voluntary blood donors with positive hepatitis type B viral′s DNA discrimination test in Guangzhou city of China.Methods A total of 296605 blood samples from blood donors in Guangzhou Blood Center from April 2015 to February 2017 were screened routinely by enzyme linked immunosorbent assay(ELISA)and transcription-mediated amplification(TMA)HBV/HCV/HIV triple nucleic acid(tNAT).The single tNAT reaction and ELISA negative samples were subjected to HBV DNA discrimination test,and the positive samples were identified by fluorescence quantitative polymerase chain reaction(Q-PCR)detection and nested PCR(N-PCR)amplification for Pre-S/S,BCP/PC gene.Serum markers of HBV were detected by Electrochemiluminescence Immunoassay(ECLIA).Results A total of 1303 single tNAT-reaction specimens were tested for discrimination.Three hundred and eighty-one(29.24%)HBV DNA-positive specimens were detected and 187 were randomly selected for Q-PCR detection and N-PCR amplification.Forty-four(23.53%)samples were positive for viral load,143 samples(76.47%)were negative for viral load.In addition,139 pre S/S genes were detected,128 BCP/PC genes were detected.One hundred and forty-eig samples(85.06%)with occult HBV infection(OBI),3 samples(1.72%)in window phase(WP),7 clearance samples(4.02%)and 16 unclassified samples(9.20%)were found among 174 HBV DNA-positive samples.There were 139 pre-S/S gene fragments,including 93(66.91%)genotype B cases and 46(33.09%)genotype C cases.Conclusions HBV B genotype is prevalent among blood donors with positive HBV DNA discrimination in Guangzhou.There are HBV-infected patients among the tNAT-reaction voluntary blood donors,and the proportion of OBI is much higher than that of WP infection.Therefore,it is important to exclude blood donors with single tNAT reaction for the prevention of HBV transmission through blood transfusion.

关 键 词：核酸检测 HBV感染 HBV基因分型 无偿献血者 广州 

分 类 号：R512.62[医药卫生—内科学]