HBsAg+&HBV DNA-的HBV感染的血清学和分子生物学特性  

Serological and molecular characterization of HBV infection with HBsAg reactive and HBV DNA non-reactive

作　　者：李春祥[1] 郭笑寒 孙鹏 刘笑春 刘丹[1] 周磊[1] 臧亮[1] Daniel Candotti 邓雪莲[1] LI Chunxiang;GUO Xiaohan;SUN Peng;LIU Xiaochun;LIU Dan;ZHOU Lei;ZANG Liang;Daniel Candotti;DENG Xuelian(Dalian Blood Center,Dalian 116001,China.;Department of Virology,Henri Mondor Hospital,AP-HP,University of Paris-Est,INSERM U955,IMRB,Créteil,France)

机构地区：[1]大连市血液中心,辽宁大连116001 [2]Department of Virology,Henri Mondor Hospital,AP-HP,and University of Paris-Est,INSERM U955,IMRB,Créteil,France

出　　处：《中国输血杂志》2022年第9期950-954,共5页Chinese Journal of Blood Transfusion

基　　金：中国输血协会圣湘输血医学发展基金(CSBT-SX-2021-02);大连市医学科学研究计划项目(1911093)。

摘　　要：目的探索血液筛查结果为HBsAg+&HBV DNA NR的HBV感染的血清学和分子生物学特性。方法通过重复核酸检测、PEG沉降病毒富集联合in-house的巢式PCR和实时荧光定量PCR,对HBsAg+&HBV DNA NR标本进行HBV DNA的确认、抗-HBc和HBsAg定量检测,并将HBV序列与对照组HBV慢性感染和隐匿性感染序列进行比对分析。结果2011年1月~2020年12月,共检测标本792195份,筛选出HBsAg+&HBV DNA-标本53份(1∶14947)。获得S序列3份、Pre Core/Core序列4份,确认含有HBV DNA的标本有5份。Core区域发现独特氨基酸替换(P130T、P135Q/S、R151Q、G153S、S155F),可能对病毒包装、复制产生影响。结论血液筛查结果为HBsAg+&HBV DNA NR的血液存在极低水平的HBV DNA;低水平HBV DNA可能与Pre Core/Core区域的某些突变影响病毒复制有关。选择灵敏度更好的HBsAg和HBV DNA检测试剂能够进一步降低HBV经血传播的潜在风险。Objective To investigate the serological and molecular characteristics of HBsAg+/HBV DNA non-reactive(NR)infections.Methods Samples tested as HBsAg+and HBV DNA NR were confirmed by individual NAT repeat testing,viral particle concentration by PEG precipitation combined with in-house nested PCR and real-time quantitative PCR,anti-HBc testing,and HBsAg quantification.HBV sequences were compared with those from donors with chronic and occult infection as controls.Results A total of 792195 samples were screened between January 2011 and December 2020,of which 53(1:14947)were confirmed HBsAg+/HBV DNA NR.HBV DNA was detected further in five(9.4%)samples;three S sequences and four Pre Core/Core sequences were obtained.Unique amino acid substitutions(P130T,P135Q/S,R151Q,G153S and S155F)were found in the Core protein that may affect virus packaging and replication.Conclusion Extremely low HBV DNA level was detected in plasmas of HBsAg+/HBV DNA NR donors.Barely detectable HBV DNA might be associated with unusual mutations in the Pre Core/Core protein affecting viral replication.More sensitive HBV DNA and/or HBsAg assays may be considered to further reduce the potential HBV transfusion-transmission residual risk.

关 键 词：血液筛查 HBSAG阳性 核酸检测 HBV感染 发生机制 

分 类 号：R457.1[医药卫生—治疗学] R373.2[医药卫生—临床医学]