隐匿性乙型肝炎病毒感染的输血传播风险及防范  

Risk and prevention of blood transfusion transmission of occult hepatitis B virus infection

作　　者：王全慧 潘彤(综述) 樊晶(审校)[1] WANG Quanhui;PAN Tong;FAN Jing(Tianjin Municipal Blood Center,Tianjin 300110,China)

机构地区：[1]天津市血液中心,天津300110

出　　处：《检验医学与临床》2024年第6期838-841,861,共5页Laboratory Medicine and Clinic

摘　　要：乙型肝炎病毒(HBV)感染是我国重大的公共卫生问题,也是输血安全领域的焦点之一。隐匿性乙型肝炎病毒感染(OBI)是HBV感染的一种特殊的临床类型,其特征是在血清或肝脏中检测到HBV DNA,但乙型肝炎表面抗原(HBsAg)呈阴性。对献血者进行HBsAg检测尤其是核酸检测(NAT)能有效地控制大多数HBV传播,但是残余传染风险依然存在。OBI献血者是潜在的HBV传染源,含有极低病毒载量的HBV DNA,即使是高度敏感的单人份核酸检测(ID-NAT)也可能是间歇性检测到或无法检测到。目前对于OBI检测缺乏一种标准化的、经过验证的有效方法。为了提高OBI检测的准确度,需要开发更灵敏、标准化和有效的HBsAg、HBV DNA的检测方法;同时还要深入地了解OBI发展机制,准确诊断OBI以提高输血安全性。Hepatitis B virus(HBV) infection is a major public health problem in China and is also one of the focal points in the field of blood transfusion safety.Occult hepatitis B virus infection(OBI) is a specific clinical type of HBV infection,which is characterized by detecting hepatitis B virus(HBV) DNA in serum or liver,but hepatitis B surface antigen(HBsAg) is negative.HBsAg testing of blood donors,especially nucleic acid testing(NAT),effectively controls the majority of HBV transmission,but the risk of residual infection still remains.The OBI blood donors are the potential infection sources of HBV,OBI donors contain HBV DNA with very low viral load,and even a highly sensitive individual donation nucleic acid test(ID-NAT) may be intermittent or undetectable.It is currently lack of a standardized,validated and effective method for OBI testing.In order to improve the accuracy of OBI detection,more sensitive,standardized and effective HBsAg and HBV DNA detection methods need to be developed;at the same time,the development mechanism of OBI should be deeply understood to accurately diagnose OBI for improving the safety of blood transfusion.

关 键 词：隐匿性乙型肝炎病毒感染 核酸检测 病毒载量 灵敏度 乙型肝炎病毒 

分 类 号：R457.1[医药卫生—治疗学] R512.62[医药卫生—临床医学]