菏泽市无偿献血人群隐匿性乙肝感染状况和血清学特征  

Occult hepatitis B infection status and serological characteristics of voluntary blood donors in Heze City

作　　者：周月霞 李国仓 蒋建民 王卓童 张业霞[1] 张秀华[1] ZHOU Yue-xia;LI Guo-cang;JIANG Jian-min(Department of Pharmacy and Laboratory Medicine,Heze Medical College,Shandong Heze 274000)

机构地区：[1]菏泽医学专科学校药学与检验系,山东菏泽274000 [2]菏泽医学专科学校附属医院检验科,山东菏泽274000 [3]菏泽市中心血站,山东菏泽274000

出　　处：《医学检验与临床》2025年第2期11-16,共6页Medical Laboratory Science and Clinics

基　　金：山东省医药卫生科技发展计划,项目编号:2019WS351。

摘　　要：目的:分析菏泽市无偿献血人群隐匿性乙型肝炎病毒感染的发病率、血清学特征和临床特征。方法:选取菏泽市中心血站2020年1月-2022年8月检测的127659例无偿献血者的血液标本,在进行乙肝表面抗原(HBsAg)、乙肝DNA检测后,将HBsAg(-)/HBVDNA(+)的献血者确定为隐匿性乙肝感染者,并定量检测其血液中HBeAg、Anti-HBs、Anti-HBe、Anti-HBc、HCV、TP、HIV和肝功能,分析隐匿性乙肝感染者的血清学标志物分布模式、性别、年龄、肝功能、乙肝DNA,合并HCV、TP、HIV感染的情况。结果:菏泽市无偿献血人群中隐匿性乙肝感染者60例,OBI发病率为0.047%。其中男性、45岁以上人群、血清学指标HBsAb、HBeAb、HBcAb阳性率高于非OBI患者,有统计学意义(P<0.05);OBI患者的HBcAb阳性率最高,达83.33%,HBeAb阳性率次之,为38.33%(P<0.05)。OBI患者与正常人相比,肝功能正常。HBVDNA循环次数均低于参考值60次,OBI患者体内HBVDNA含量较高。OBI感染者中有1例合并丙肝,1例合并艾滋梅毒丙肝。结论:菏泽市无偿献血人群中隐匿性乙肝的发病率为0.047%,HBcAb阳性对诊断OBI有重要意义。HBVDNA检测是发现隐匿性乙肝感染风险的有效方式。而对于HBeAb、HBcAb,尤其是HBcAb阳性者应进一步进行核酸检测,避免造成输血风险和乙肝疾病的进一步发展。Objective:To analyze the incidence,serological characteristics and clinical characteristics of occult hepatitis B virus infection in voluntary blood donors in Heze City.Methods:Blood samples of 127659 voluntary blood donors detected by Heze Central Blood Station from January 2020 to August 2022 were selected.After hepatitis B surface antigen(HBsAg)and hepatitis B DNA detection,the blood donors with HBsAg(-)/HBV DNA(+)were identified as occult hepatitis B infection,and HBeAg,Anti-HBs,Anti-HBe,Anti-HBc,HCV,TP,HIV and liver function were quantitatively detected in their blood.The distribution pattern of serological markers,gender,age,liver function,DNA,and combined infection of HCV,TP and HIV in occult hepatitis B infection were analyzed.Results:There were 60 cases of occult hepatitis B infection in voluntary blood donors in Heze City,and the incidence of OBI was 0.047%.The number of male,over 45 years old,serological indicators HBsAb,HBeAb,HBcAb positive cases were higher than that of non-OBI patients,with statistical significance(P<0.05).The positive rate ofHBcAb was the highest in OBI patients(83.33%),followed by HBeAb(38.33%)(P<0.05).Patients with OBI have normal liver function compared to normal people.The number of HBV DNA cycles was lower than the reference value of 60 times,and the content ofHBV DNA in OBI patients was higher.Among OBI infected persons,1 case was complicated with hepatitis C and 1 case was complicated with HIV and syphilis.Conclusion:The incidence of occult hepatitis B among unpaid blood donors in Heze City was O.047%.Positive HBcAb is of great significance for the diagnosis of OBI.HBV DNA testing is an effective way to detect the risk oflatent hepatitis B infection.For HBeAb,HBcAb,especially HBCAB-positive patients should be further nucleic acid testing to avoid blood transfusion risk and further development of hepatitis B disease.

关 键 词：菏泽市 无偿献血 隐匿性乙肝 感染状况 血清学特征 

分 类 号：R51[医药卫生—内科学]