广州番禺地区献血者隐匿性乙型肝炎感染情况调查  

Investigation of occult hepatitis B infection in blood donors in Panyu District,Guangzhou

作　　者：陈平萍 蓝文莉 洪飞芳 马伟文 CHEN Pingping;LAN Wenli;HONG Feifang;MA Weiwen(Central Blood Station of Panyu,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中心血站,广东广州511400

出　　处：《中国输血杂志》2024年第10期1142-1146,共5页Chinese Journal of Blood Transfusion

基　　金：番禺区科技计划项目(2021-Z04-108)。

摘　　要：目的了解广州番禺地区献血人群隐匿性乙型肝炎病毒感染(OBI)状况,为输血安全提供科学依据。方法以2021年1月1日-2023年7月31日共60872份广州番禺地区献血者标本中筛查出结果HBsAg-/HBV DNA+的献血者作为OBI研究对象,对OBI献血者的年龄、性别、献血频次进行统计分析;并进行HBV DNA病毒载量和乙肝两对半追踪检测。结果广州番禺地区献血者HBsAg-/HBV DNA+的阳性率为0.08%(50/60872)。男性献血者OBI阳性率高于女性献血者(P>0.05),献血者的OBI阳性率随年龄增长而升高(P<0.05),首次献血者的OBI阳性率高于重复献血者(P<0.05)。50名HBsAg-/HBV DNA+献血者中有42名完成1次追踪检测,其中14名没有检测到HBV DNA,其标本原始血筛拆分CT均值为37.77,乙肝两对半以单项HBsAb+为主,占50%(7/14);28名献血者检测到HBV DNA病毒载量,病毒载量<10 IU/mL占50%(14/28),病毒载量<200 IU/mL占96%(27/28),其标本原始血筛拆分CT均值为34.55,乙肝两对半以HBeAb+/HBcAb+为主,占32.14%(9/28)。24名献血者多次追踪均检测到病毒载量占37.5%(9/24),都检测不到的占33.33%(8/24),检测结果时阴时阳的占29.17%(7/24);乙肝两对半结果模式7名有变化,占29.17%(7/24),没有变化的占70.83%(17/24)。结论年轻的重复献血者OBI感染率较低。OBI是多种复杂机制导致的结果,现有的血清学核酸检测技术还不能检出所有OBI献血者,严格的献血前征询和对既往HBV DNA+献血者屏蔽对于血液安全非常重要。建议器官移植、肿瘤放化疗或使用免疫抑制药物等免疫力低下的患者,使用病毒灭活血液制品。Objective To investigate the status of occult hepatitis B virus infection(OBI)among blood donors in Panyu District of Guangzhou,so as to provide reference for blood transfusion safety.Methods From January 1,2021 to July 31,2023,60872 blood donors in Panyu District with HBsAg-/HBV DNA+were screened as OBI subjects.The age,gender and frequency of blood donation of OBI donors were statistically analyzed.HBV DNA viral load was detected and hepatitis B five-panel test was performed.Results The HBsAg-/HBV DNA+positive rate of blood donors in Panyu District was 0.08%(50/60872).The OBI positive rate of male blood donors was higher than that of female blood donors,with no statistically significant difference(P>0.05).The OBI positive rate of blood donors increased with age,with statistically significant difference(P<0.05).The OBI positive rate of first-time blood donors was higher than that of repeat blood donors,with statistically significant difference(P<0.05).Of the 50 HBsAg-/HBV DNA+donors,42 had a follow-up test,among which 14 had no HBV DNA detected.The mean value of the initial screening resolution CT was 37.77.In hepatitis B five-panel test,single HBsAb+accounted for the highest proportion as 50%(7/14).HBV DNA viral load was detected in 28 cases,and viral load<10 IU/mL accounted for 50%(14/28)and that<200 IU/mL accounted for 96%(27/28).The mean value of initial screening resolution CT was 34.55,mainly HBeAb+/HBcAb+in hepatitis B five-panel test,accounting for 32.14%(9/28).After multiple follow-up of 24 blood donors,37.5%(9/24)were detected with viral load,33.33%(8/24)were detected with no viral load,and 29.17%(7/24)had both negative and positive results.The hepatitis B five-panel test outcome of 29.17%(7/24)donors showed a turnover,while 70.83%(17/24)did not.Conclusion The OBI infection positive rate is lower in young repeat blood donors.Since OBI is the result of a variety of complex mechanisms,and the existing serological NAT cannot detect all OBI donors,strict pre-donation consultation and screening of previous

关 键 词：献血者 OBI 乙肝两对半 核酸检测 HBV DNA 定量 

分 类 号：R457.1[医药卫生—治疗学] R446[医药卫生—临床医学] R512.62