宁波地区献血者戊型肝炎病毒感染情况调查  

Hepatitis E virus infection among blood donors in Ningbo

作　　者：彭明喜 刘奕宇 毛湖燕 林丹 忻璐 舒宁 韩剑锋 丁峰 PENG Mingxi;LIU Yiyu;MAO Huyan;LIN Dan;XIN Lu;SHU Ning;HAN Jianfeng;DING Feng(Ningbo Central Blood Station,Ningbo 315040,China;Medical Affairs Department,Sansure Biotech Inc,Changsha 410205,China;Institute of Life Sciences,Sansure Biotech Inc,National and local Joint Engineering Research Center for Infectious Diseases and Tumor Gene Diagnosis Technology,Changsha 410205,China)

机构地区：[1]宁波市中心血站,浙江宁波315040 [2]圣湘生物科技股份有限公司医学事务部,湖南长沙410205 [3]圣湘生物科技股份有限公司生命研究院,感染性疾病及肿瘤基因诊断技术国家地方联合工程研究中心,湖南长沙410205

出　　处：《中国输血杂志》2025年第1期7-12,共6页Chinese Journal of Blood Transfusion

基　　金：中国输血协会圣湘发展基金资助项目(CSBT-SX-2021-03)。

摘　　要：目的了解宁波地区无偿献血者戊型肝炎病毒(hepatitis E virus,HEV)的感染状况及特征,为完善血液筛查策略提供依据。方法对宁波地区2022年6月—2023年5月12227份无偿献血者血液标本进行HEV血清学、酶学和核酸检测,且进一步对HEV基因序列进行分型分析,并对核酸检测结果呈反应性的献血者进行追踪随访以确认其感染状况。结果HEV Ag反应性率为0.098%;抗-HEV IgM反应性率为0.899%;抗-HEV IgG反应性率为29.198%。抗-HEV IgM和抗-HEV IgG反应性在不同性别、献血次数、献血类型的献血者间无差异(P>0.05),献血者抗-HEV反应性率随着年龄的增长而升高(P<0.05),HEV Ag反应性标本ALT不合格(ALT>50U/L)率明显高于无反应性标本(P<0.05);HEV Ag反应性率(0.098%)与献血者性别、献血次数、献血类型及年龄均无相关性。HEV RNA阳性1例,阳性率0.008%(1/12227),经测序分析,确认为HEV基因3型,除HEV Ag反应性外,其他血液安全筛查项目均为无反应性,推测本次可能为急性感染期。追踪随访结果显示该献血者前次献血各项指标均为无反应性。结论献血前ALT检测可以一定程度上减少输血传播HEV(transfusion-transmitted HEV,TT-HEV)风险,防止TT-HEV切实有效的途径只能是献血者血液HEV RNA及血清学筛查。Objective To investigate the infection status and characteristics of HEV among voluntary blood donors in Ningbo,and to provide a basis for improving the blood screening strategy.Methods A total of 12227 blood samples from voluntary blood donors in Ningbo from June 2022 to May 2023 were tested for HEV serology,enzymology,and nucleic acid testing.Furthermore,HEV gene sequencing was performed for genotyping analysis,and donors with reactive nucleic acid testing results were followed up to confirm their infection status.Results The reactivity rate of HEV Ag,anti-HEV IgM and anti-HEV IgG was 0.098%,0.899%and 29.198%,respectively.There was no difference in the reactivity of anti-HEV IgM and anti-HEV IgG between genders,donation frequencies and donation types(P>0.05).The reactivity rate increased significantly with age(P<0.05).The rate of ALT disqualification(ALT>50U/L)was significantly higher than that in nonreactive samples(P<0.05).The HEV Ag reactivity rate(0.098%)was not correlated with gender,donation frequency,donation type or age.One HEV RNA positive case was found,with a positive rate of 0.008%(1/12227).It was confirmed to be hepatitis E virus genotype 3 by sequencing analysis.Apart from HEV Ag reactivity,all other blood safety screening items were non-reactive,suggesting this case might be in the acute infection phase.The follow-up results showed that all indicators of the donor′s previous blood donation were non-reactive.Conclusion Pre-donation ALT detection can reduce the risk of transfusion-transmitted HEV(TT-HEV)to a certain extent,and the effective way to prevent TT-HEV is to detect HEV RNA and serology of donor blood.

关 键 词：献血者 戊型肝炎病毒 血液筛查 核酸检测 基因分型 

分 类 号：R457.1[医药卫生—治疗学] R373.2[医药卫生—临床医学] R446