HBsAg不同状态下NAT反应性献血者血清学标志物特征分析  

Characteristics analysis of HBV serological markers of NAT reactive blood donors under different HBsAg status

作　　者：倪德群 王婷婷 王婷 李明睿 崔伟娅 谢欣 何晴 李素萍[1] NI Dequn;WANG Tingting;WANG Ting;LI Mingrui;CUI Weiya;XIE Xin;HE Qing;LI Suping(Anhui Blood Center,Hefei230031,China)

机构地区：[1]安徽省血液中心,安徽合肥230031

出　　处：《中国输血杂志》2023年第1期69-72,共4页Chinese Journal of Blood Transfusion

基　　金：合肥市卫健委2019年应用医学研究项目(hwj2019zd018)。

摘　　要：目的 了解HBsAg不同状态下核酸检测(NAT)反应性献血者HBV血清学标志物特征。方法 收集2021年9月~2022年5月核酸检测反应性标本,且ELISA检测HBsAg-/初筛HBsAg+复检阴性/单试剂HBsAg+标本,TMA鉴别非反应性标本加做罗氏PCR单人份复检,用电化学发光免疫法(ECLI)定量检测乙肝两对半进行统计分析。结果 共收集66份标本,HBsAg-/NAT+标本55份,抗-HBc阳性率为87.3%(48/55),抗-HBs、抗-HBc 2项阳性率为43.6%(24/55),抗-HBe、抗-HBc 2项阳性率为45.5%(25/55),单项抗-HBs阳性率为10.9%(6/55)和全阴性占比1.8%(1/55);酶免初筛HBsAg+复检阴性/NAT+标本7份,抗-HBc阳性率为100%(7/7),抗-HBe、抗-HBc 2项阳性率为71.4%(5/7);单试剂HBsAg+/NAT+标本4份,HBsAg、抗-HBs、抗-HBe、抗-HBc 4项阳性率为50%(2/4),抗-HBe、抗-HBc 2项阳性率为100%(4/4)。TMA鉴别非反应性且抗-HBc-标本PCR单人份复检为非反应性。在HBsAg-/NAT+标本与单试剂HBsAg+/NAT+标本中抗-HBe、抗-HBc 2项均阳性有差异(P<0.05)。结论 HBsAg-/NAT+献血者大多数为隐匿性乙型肝炎病毒感染,抗-HBe、抗-HBc 2项均阳性与HBV感染状态具有相关性,TMA鉴别非反应性且抗-HBc-不排除HBV DNA非反应性。Objective To investigate the characteristics of HBV serological markers of NAT reactive blood donors under different HBsAg status. Methods NAT reactive samples, with HBsAg-, HBsAg+/retest-and HBsAg+ by single reagent were collected from September 2021 to May 2022 in our laboratory. The TMA non-reactive samples were retested by Roche PCR, then HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were detected by ECLI for statistical analysis. Results A total of 66 samples were collected, among which 55 were HBsAg-/NAT+. The positive rate of anti-HBc, anti-HBs+anti-HBc, anti-HBe+anti-HBc was 87.3%(48/55), 43.6%(24/55) and 45.5%(25/55), respectively. The positive rate of anti-HBs was 10.9%(6/55) and the overall negative rate was 1.8%(1/55). In 7 HBsAg+ initially/retest-/NAT+ samples, the positive rate of anti-HBc was 100%(7/7), and the positive rate of anti-HBe+anti-HBc was 71.4%(5/7). In 4 HBsAg+/NAT+ samples by single reagent, the positive rate of HBsAg+ anti-HBs+anti-HBe+anti-HBc was 50%(2/4), and positive rate of anti-HBe+anti-HBc was100%(4/4). Samples, not reactive to TMA discriminatory and anti-HBc negative, were also non-reactive to individual PCR retest. There were significant differences in the positive rates of anti-HBe+anti-HBc between HBsAg-/NAT+ samples and HBsAg+/NAT+(single reagent) samples(P<0.05). Conclusion Most HBsAg-/NAT+ blood donors were occult hepatitis B virus infection.The anti-HBe+anti-HBc positive were correlated with HBV infection status. Non-reactivity discriminated by TMA plus anti-HBc negative do not exclude HBV DNA non-reactivity.

关 键 词：核酸检测 乙肝表面抗原 乙型肝炎病毒 血清学标志物 

分 类 号：R457.1[医药卫生—治疗学] R446[医药卫生—临床医学] R373.2