隐匿性乙肝病毒感染献血者HBV分子生物学特性及追踪研究  

HBV Molecular Biological Characteristics And Follow-up of Occult Hepatitis B Virus Infection in Voluntary Blood Donors

作　　者：肖晨 Xiao Chen(Shandong Blood Center,Jinan Shandong 250014,China)

机构地区：[1]山东省血液中心,山东济南250014

出　　处：《生命科学仪器》2024年第3期71-74,共4页Life Science Instruments

基　　金：山东省医药卫生科技发展计划项目(2019WS542)。

摘　　要：目的了解献血者隐匿性乙肝病毒感染情况及输血传播风险。方法对2020年至2023年山东省两地市献血者血液标本采用两种酶联免疫吸附测定(ELISA)试剂和1种核酸试剂进行检测,对其中乙肝表面抗原(HBsAg)无反应性、HBV DNA反应性标本进行乙肝五项检测,电话调查献血者乙肝疫苗接种史及家庭成员感染HBV情况,并询问其参与随访的意愿,对配合随访的献血者采血检测HBV DNA和乙肝五项,观察HBV血清学和分子生物学特性的变化。结果786000例献血者中,共检出285例HBsAg无反应性、HBV DNA反应性标本。285例标本中,HBsAg-/HBcAb+标本有237例,占83.16%(237/285)。36例配合随访的献血者中,32例献血者初步判定为OBI,2例献血者为HBsAg检测窗口期,2例献血者为NAT初次检测假反应性。结论乙肝疫苗接种有效降低了乙肝感染率,HBV DNA检测可缩短HBsAg检测“窗口期”,并有效检出OBI,降低输血感染风险,保障临床用血安全。Objective:To explore the occult hepatitis B virus infection in voluntary blood donors of Jinan and Binzhou.Methods:Blood samples collected from voluntary blood donors during 2020 to 2023 in Jinan and Binzhou were tested by ELISA twice and NAT once.Then HBsAg and HBcAb were analyzed on HBV DNA reactive samples implicated in nonreactive ELISA.Call these blood donors to investigate the status of hepatitis B vaccine immunization and HBV infection of their family members.HBV DNA and five hepatitis B items were analyzed for follow-up blood donors in order to get the changes of serological and molecular biological characteristics.Results:285 out of 786000 blood samples were detected positive by NAT but were non-reactive in the primary ELISA screening,and 237(83.16%)of them were detected HBcAb positive.36 blood donors were followed up.Based on the results of follow-up tests,32 were identified as occult hepatitis B virus infection(OBI),2 as“window period”HBV infection,2 as false positive in initial NAT.Conclusion:Vaccination has effectively reduced the rate of hepatitis B infection.NAT can detect the OBI and shorten the“window period”effectively,so then reduce residual risk of transfusion transmissible infection.

关 键 词：献血者 隐匿性乙肝病毒感染 核酸检测 乙肝疫苗接种 

分 类 号：R512.62[医药卫生—内科学]