献血者HBsAg阴性NAT可疑标本HBV感染状态确认  

Confirmation of HBV infection of HBsAg-negative NAT suspicious sample from blood donors

作　　者：王全慧 樊晶[1] WANG Quanhui;FAN Jing(Tianjin Blood Center,Tianjin 300110,China.)

机构地区：[1]天津市血液中心,天津300110

出　　处：《中国输血杂志》2023年第12期1110-1114,共5页Chinese Journal of Blood Transfusion

摘　　要：目的了解天津地区无偿献血者应用PANTHER单人份核酸检测(ID-NAT)后,联检反应性,鉴别试验阴性(NAT可疑)标本HBV感染情况。方法本中心2021年1—8月69362份无偿献血者标本经常规检测和ID-NAT检测后,共检出HBsAg-PANTHER核酸检测联检反应性而鉴别非反应性献血者标本(以下简称NAT可疑标本)66份。采用单纯随机抽样方法选取23份应用超高速离心富集病毒后,采用超敏荧光定量PCR(qPCR)检测HBV DNA,ID-NAT复测鉴别实验,补充电化学发光法乙肝两对半检测。结果23份NAT可疑标本中经血清学和分子生物学检测共确认HBV DNA阳性14份,HBV感染者抗-HBc阳性率为92.8%。感染者中92.8%(13/14)为隐匿性乙型肝炎病毒感染(OBI)。超敏荧光定量PCR检测共有10份标本获得病毒载量,5份可定量,病毒载量定量(11~464)IU/mL,中位数为15.4 IU/mL。结论NAT可疑标本中仍能检出60%标本为HBV DNA阳性。抗-HBc检测能排除大多数NAT无法检测到的OBI,应提高目前NAT检测灵敏度,确保输血安全。Objective To explore the HBV infection of initially reactive but discriminatory test non-reactive(NAT suspicious)samples of voluntary blood donors after PANTHER individual nucleic acid testing(ID-NAT)in Tianjin.Methods From January to August 2021,after routine testing and PANTHER ID-NAT,a total of 66 HBsAg-NAT reactive but discriminatory test non-reactive samples(referred to as NAT suspicious samples)were tested from 69362 blood samples.Among which,23 samples were selected by simple random sampling method and enriched by ultra-high speed centrifugation.HBV DNA was detected by supersensitive fluorescence quantification PCR(qPCR)and ID-NAT,and electrochemiluminescence was supplemented for two and half pairs of hepatitis B detection.Results Among 23 suspicious NAT samples,14 were confirmed HBV DNA positive by serological and molecular biological tests,and the anti-HBc positive rate of HBV infected individuals was 92.8%.92.8%(13/14)of the infected individuals were occult hepatitis B virus infection(OBI).A total of 10 samples were detected for viral load by qPCR,of which 5 were quantifiable,with viral load of(11~464)IU/mL and a median of 15.4 IU/mL.Conclusion 60%of the NAT suspicious samples were detected as HBV DNA positive.Anti-HBc testing can exclude most OBI undetectable by NAT,and the sensitivity of NAT should be improved to ensure the safety of blood transfusion.

关 键 词：单人份核酸检测 隐匿性乙型肝炎病毒感染 荧光定量 电化学发光法 

分 类 号：R446.4[医药卫生—诊断学]