郑州地区HBsAg-HBV DNA+献血者的乙肝血清学特征分析  

Analysis of onserological characteristics of HBsAg-HBV DNA+voluntary blood donors in Zhengzhou

作　　者：王艺芳[1] 魏旖辉 赵磊[1] 陈明军[1] 魏跃光 吕永磊[1] WANG Yi-fang;WEI Yi-hui;ZHAO Lei;CHEN Ming-jun;WEI Yue-guang;LVE Yong-lei(Henan Red Cross Blood Center,Zhengzhou 450012,China)

机构地区：[1]河南省红十字血液中心,郑州450012

出　　处：《医药论坛杂志》2024年第13期1409-1413,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210269)。

摘　　要：目的了解郑州地区HBsAg无反应性HBV DNA反应性(HBsAg-HBV DNA+)献血者乙肝血清学标志物特征。方法2017年9月—2019年12月本研究采用2个不同厂家ELISA检测试剂同时进行HBsAg、抗-HCV和抗-HIV1/2(ELISA双反应性的标本除外)ELISA检测后的血液标本,进行核酸检测(nucleic acid testing,NAT),并收集HBsAg-HBV DNA+标本采用化学发光法检测进行乙肝血清学补充试验。结果经ELISA检测后有562666例进行了核酸检测,其中351例为HBV DNA反应性,经核酸检测后HBV残余风险降低至6.24/万。351例HBsAg-HBV DNA+标本经化学发光法检测发现,其中5例标本为HBsAg阳性;346例标本为HBsAg-HBV DNA+,其中有30例(8.67%)可能为“窗口期”感染,316例(91.33%)可能为“隐匿性”HBV感染(occult hepatitis B virus infection,OBI);乙肝血清学模式以单独HBcAb阳性(33.33%),HBsAb、HBcAb共阳性(20.51%)及HBeAb、HBcAb共阳性(17.09%)三种模式为主;60.40%HBsAb定量值<10 IU/L,15.10%HBsAb定量值>100 IU/L。HBsAb阳性组的HBV DNA复检反应性率37.41%明显低于HBsAb阴性组59.43%(χ^(2)=16.292,P<0.001)。351例HBsAg-HBV DNA+献血者中随着年龄的增长,HBcAb阳性比例上升,以46~55年龄段为最高(92.80%)。结论HBV感染多以“隐匿性”感染为主,呈现特定的血清学模式,其中>26岁年龄段HBcAb阳性人群、HBsAb阴性人群都可能存在较高的输血传播HBV的风险。核酸检测的应用能有效降低经输血传播HBV的残余风险,提高血液的安全性。Objective To understand the characteristics of hepatitis B serological markers in voluntary blood donors with HBsAg non-reactive HBV DNA reactivity(HBsAg-HBV DNA+)in Zhengzhou.Methods After simultaneously tested by two different ELISA reagents for HBsAg,anti-HCV and anti-HIV1/2,562666 blood donors samples(except for ELISA dual-reactive samples)was performed by Nucleic Acid Testing(NAT).HBsAg-HBV DNA+samples were collected for supplementary hepatitis B serological test by chemiluminescence detection.Results Totally 351 cases were HBV DNA reactive,and the residual risk rate of HBV was reduced to 624/10000 after NAT.351 HBsAg-HBV DNA+samples were tested by chemiluminescence detection,of which 5 samples were HBsAg positive;346 samples were HBsAg-HBV DNA+,of which 30 samples(8.67%)were window period infection,and 316(91.33%)samples were occult HBV infection;the proportion of the hepatitis B serological HBcAb positive pattern was 33.33%,the proportion of HBsAb and HBcAb positive was 20.51%,the proportion of HBeAb and HBcAb positive was 17.09%;the proportion of HBsAb Quantitative value<10 IU/L was 60.40%,the proportion of HBsAb quantification value>100 IU/L was 15.10%.The re-detection coincidence rate of HBV DNA in the HBsAb-positive group was 37.41%,which was significantly lower than that in the HBsAb-negative group(59.43%,χ^(2)=16.292,P<0.001).Among the 351 HBsAg-HBV DNA+blood donors,the positive rate of HBcAb increased with the increase of age,and the highest positive rate(92.80%)was in the age group of 46-55.Conclusion HBV infection was mostly occult HBV infection,presenting a specific serological pattern.HBcAb-positive and HBsAb-negative blood donors in the>26-year-old age group may have a higher risk of transfusion-transmitted HBV.The application of NAT can effectively reduce the residual risk of HBV transmission through blood transfusion and improve the safety of blood.

关 键 词：核酸检测 窗口期 隐匿性HBV感染 血液安全 

分 类 号：R512.62[医药卫生—内科学]