Evaluation of a multiplex human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus nucleic acid testing assay to detect viremic blood donors in northern Thailand

BACKGROUND: Screening of blood donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) has been implemented recently in the United States. There are limited data, however, on the additional NAT yield of donors in developing countries in Asia where the prevalence of infection is higher. In addition, data on hepatitis B virus (HBV) NAT in high prevalence areas are minimal. STUDY DESIGN AND METHODS: A total of 5083 whole-blood donors at the Chiang Mai University Hospital, Thailand, blood bank were evaluated with a commercially available NAT assay (Procleix Ultrio, Gen-Probe, Inc.) to screen individual donations. RESULTS: No NAT yield cases were found for HIV-1 or HCV. There were 17 samples with discrepant HBV DNA NAT and hepatitis B surface antigen (HBsAg) tests, however. Seven of these were HBV DNA NAT-positive, HBsAg-negative; of these 7, 1 was NAT-positive at baseline, but negative on follow-up, and considered a false-positive, 1 had an acute infection, and 5 had chronic prevalent HBV infections, for a NAT yield of 6 in 4798 HBsAg negative donors (1:800). In addition there were 10 NAT-negative, HBsAg-positive serum samples. All were anti-hepatitis B core antigen immunoglobulin G-positive; on testing with a more sensitive NAT target capture assay, 5 were positive (1.8-20.6 IU/mL) and 5 were negative. CONCLUSION: Multiplex NAT screening of individual-donor serum samples in Northern Thailand detected approximately 1 per 800 HBV NAT-positive, HBsAg-negative donors. The especially high prevalence of HBV infection in Thailand and other Asian countries suggests that HBV NAT screening of donors will be more cost-effective than in other areas.     

Neopterin levels during the early phase of human immunodeficiency virus, hepatitis C virus, or hepatitis B virus infection

BACKGROUND: A study was conducted to assess the diagnostic sensitivity of neopterin screening of blood donors with regard to the detection of window-phase specimens of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infection. STUDY DESIGN AND METHODS: In total, 1002 diagnostic window-phase specimens from 98 seroconversion panels (29 HIV-1, 52 HCV, and 17 HBV) were analyzed with viral antigen detection, viral nucleic acid amplification testing (NAT), and neopterin quantitation assays. The study was completed by the analysis of 92 anti-hepatitis B core antigen (HBc)-reactive and 103 alanine aminotransferase (ALT)-elevated blood donor specimens. RESULTS: A significant association between elevated neopterin concentrations and the very early phase of HIV-1 infection was found. No significant correlation could be observed between neopterin levels and the early phase of HCV or HBV infection. Neopterin concentration was not increased in specimens from blood donors with anti-HBc reactivity or ALT elevation. CONCLUSIONS: Neopterin screening of blood donors may identify window-phase cases of HIV, but not of HCV or HBV infection. The diagnostic sensitivity of neopterin screening during the HIV window phase is similar to that of the p24 antigen test. With the introduction of viral NATs in blood screening, there is no additional benefit of neopterin screening with regard to the three blood-borne viruses HIV, HCV, and HBV. Acute phases of other infectious agents, however, have been reported to be detected by neopterin enzyme-linked immunosorbent assays.     

Multicenter performance evaluation of a transcription-mediated amplification assay for screening of human immunodeficiency virus-1 RNA, hepatitis C virus RNA, and hepatitis B virus DNA in blood donations

BACKGROUND: The performance of the recently launched Procleix Ultrio (Chiron/Gen-Probe) human immunodeficiency virus-1 (HIV-1), hepatitis C virus (HCV), and hepatitis B virus (HBV) blood screening assay was evaluated in a European multicenter study. STUDY DESIGN AND METHODS: Serial dilutions of reference materials were tested to determine the detection limits. Robustness and specificity were assessed by testing alternating high-load HCV RNA-positive and -negative samples, and 2912 test pools of eight donations. The added value of minipool and single-donation HBV nucleic acid testing protocols was compared to the currently used Prism (Abbott GmbH & Co. KG) hepatitis B surface antigen (HBsAg) and Auszyme (Abbott GmbH & Co. KG) dynamic HBsAg tests in 15 HBV seroconversion panels. RESULTS: The 95 percent detection limits (and 95% confidence interval [CI]) on the WHO International Standards was 26 (16-58) IU per mL for HIV-1 RNA, 4.6 (3.7-6.5) IU per mL for HCV RNA, and 11 (7.3-22) IU per mL for HBV DNA. No cross-contamination was observed. Testing 2912 pools of eight donations revealed 16 initial reactive samples; 11 were confirmed. The specificity after initial testing and percentage of invalid results were 99.83 and 0.48 percent, respectively. The HBV window-period (WP) reductions relative to HBsAg seroconversion in Prism and Auszyme dynamic HBsAg were, respectively, 6 days (95% CI, 3-8) and 9 days (95% CI, 7-12) in 1:8 minipool (MP) testing. CONCLUSION: The performance characteristics of Procleix Ultrio assay and the Procleix HIV-1 and HCV assay are comparable. The sensitivity for HIV-1 and HCV met the directives of the Paul-Ehrlich Institute and the FDA. The assay can reduce the WP for HBV by 6 days to 2 weeks when used in small MP (<1:8) or single-donation screening protocols.     

Prevalence of hepatitis G virus RNA and antibodies to HGV envelope protein (anti-E2) in patients with liver injury in Japan]

To assess the role of hepatitis G virus (HGV) in acute and chronic liver diseases, we investigated the prevalence of HGV RNA and antibodies to HGV envelope protein (anti-E2) among patients with liver diseases diagnosed in our hospital from 1992 to 1997. Among 24 patients with acute hepatitis (HAV: 13, HBV: 2, HCV: 3, CMV: 1, non A-C: 5), only 1 patient with non A-C hepatitis (4%) were positive for HGV RNA and none was positive for anti-E2. Among 461 patients with chronic liver diseases (alcohol: 27, HBV: 74, HCV: 297, HBV + HCV: 10, non B non C: 14, autoimmune and metabolic: 39), 40 patients (alcohol: 1, HBV: 3, HCV: 33, HBV + HCV: 3) were positive for HGV RNA(9%) and 48 patients were positive for anti-E2(17%). In the patients with positive for anti-E2, only 8% were positive for HGV RNA. 98% of HGV RNA positive patients were infected with HBV or HCV, and especially 82% were infected with HCV. In patients with non A-C hepatitis, none was positive for HGV RNA, so HGV seems not to have important role in liver diseases.     

乙型肝炎病毒感染者前S1抗原检测的临床意义

目的分析乙型肝炎病毒（HBV）前S1抗原（PreS1Ag）与其他HBV标志物的关系,并探讨其相应的临床意义。方法采用酶联免疫吸附试验（ELISA）和聚合酶链反应（PCR）方法对218例乙型肝炎（下称乙肝）患者和30例健康者进行HBV血清标志物、HBVPreS1Ag和HBVDNA检测。结果在所检人群中PreS1Ag和HBVDNA的检出率分别为62．5％和63．7％。在乙肝e抗原（HBeAg）阳性组和阴性组中PreS1Ag阳性率为87．2％和59．8％,HBVDNA阳性率为95．7％和57．1％。PreS1Ag和HBVDNA的阳性率相似。结论PreS1Ag是HBV感染、复制的指标,与HBV血清标志物联合检测可为乙肝的诊断和治疗提供可靠依据。     

Donor screening for antibody to hepatitis B core antigen and hepatitis B virus infection in transfusion recipients

BACKGROUND: Testing for antibody to hepatitis B core antigen (anti-HBc) as a surrogate for hepatitis C viremia is no longer needed for blood donor screening. Currently, the important question is how much its use supplements hepatitis B surface antigen (HBsAg) donor screening in preventing transfusion-transmitted hepatitis B virus (HBV) infection. STUDY DESIGN AND METHODS: In a study conducted in the 1970s, 64 blood donors were associated with 15 cases of HBV (1.0%) in 1533 transfusion recipients. Sera from 61 donors at donation and 29 follow-up visits were available for present-day assays for HBsAg, HBV DNA, anti-HBc, and antibody to HBsAg (anti-HBs). RESULTS: HBsAg was found in four previously negative blood donors; HBV DNA was limited to three of these four. Anti-HBc was detected in six HBsAg-negative donors. Two other donors were negative in all assays at donation, but positive for anti- HBc and anti-HBs 2 to 4 months later. The remaining donors were negative for all HBV markers, which left five recipient cases unexplained. No HBV transmission was observed when anti-HBs sample-to- negative control values were > or = 10. CONCLUSION: Some 33 to 50 percent of cases of hepatitis B that could be transmitted by transfusion of blood from HBsAg-negative donors are prevented by anti- HBc screening. Anti-HBc-positive donors unequivocally positive for anti- HBs should be considered noninfectious for HBV and should be allowed to donate. Anti-HBc screening of paid plasmapheresis donors, supplemented by anti-HBs testing, would reduce the amount of HBV to be processed by virus inactivation and increase the content of anti-HBs in plasma pools.     

多重定量PCR法同步检测HBV、HCV和HIV-1在血液筛查中的优化及应用

目的 初步探讨多重定量聚合酶链反应（PCR）同步检测乙型肝炎病毒（HBV） DNA,丙型肝炎病毒（HCV） RNA及人类免疫缺陷病毒（HIV）-1 RNA在血液筛查中的应用前景.方法 选择2012年8月至12月,于孝感市中心血站志愿献血的合格献血者血样中,经2次酶联免疫吸附法（ELISA）检测HBV表面抗原（HBsAg）、抗HCV及抗HIV-1,检测结果均呈阴性的4 800份血样为研究对象.采用全自动核酸混合提取仪对该4 800份血样进行核酸提取,然后利用多重定量PCR方法对血样中HBV、HCV及HIV-1进行同步扩增检测.采用中国药品和生物制品检定所提供的HBV DNA、HCV RNA及HIV-1 RNA标准参考品,检测多重定量PCR的灵敏度,并与单重定量PCR的灵敏度进行比较.在HBV、HCV及HIV-1 3者中任意1种病毒基因组浓度较高的条件下,对多重定量PCR检测另2种低浓度病毒基因组的能力进行评估.结果 增加多重定量PCR中c-MMLV逆转录酶和Hot Taq酶的用量,并适量加入单链结合蛋白（SSB）,可使其扩增效率提升至单重定量PCR扩增水平.本组4 800份血样中,经多重定量PCR检测出3份HBV DNA阳性样品,ELISA漏检率为0.062 5％,未发现HCV RNA和HIV-1 RNA阳性样品;多重定量PCR检测HBV DNA、HCV RNA及HIV-1 RNA在95％置信区间的灵敏度浓度分别为115 IU/mL、376 IU /mL和232 IU /mL;单重定量PCR检测HBV DNA、HCV RNA和HIV-1 RNA在95％置信区间的灵敏度浓度分别为51 IU /mL、94 IU /mL和78 IU/mL.结论 本研究初步建立了对献血者血液同时进行HBV DNA、HCV RNA及HIV-1 RNA检测的多重定量PCR检测方法;该检测体系经过进一步优化后,有望应用于临床大规模血液病毒筛查.     

血液透析患者肝炎病毒感染危险因素分析

目的 了解血液透析患者乙型、丙型和庚型肝炎病毒(HBV、HCV和HGV)感染及合并感染的危险因素。方法 采用酶联免疫法(ELISA)检测了44例血透患者的HBV标志物、抗-HCV和抗-HGV抗体,逆转录-套式PCR法检HCV BNA及HGV RNA。结果 血透患者三种肝炎总感染率达77.3％,HBV、HCV、HGV感染率分别为72.7％、13.6％和13.6％,HBV/HCV、HCV/HGV、HGV/HBV合并感染分别为11.4％、2.3％和11.4％,HBV、HCVT HGV三重感染率为2.3％。HCV感染与输血次数、透析年限明显相关,而HBV和HGV感染与输血次数、透析年限无显著相关。肝炎病毒合并感染组与单纯感染组、阴性组比较,输血次数明显增多、透析年限明显延长。结论 血透患者HBV、HCV和HGV感染率均较高。严格消毒措施,减少输血,血源筛查,对减少透析中肝炎病毒感染至关重要。     

Comparison of two automated nucleic acid testing systems for simultaneous detection of human immunodeficiency virus and hepatitis C virus RNA and hepatitis B virus DNA

BACKGROUND: Recently developed nucleic acid testing (NAT) assays incorporating simultaneous detection of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) have made HBV NAT screening more feasible for blood services. This study compared the performance of two "multiplex" NAT assays and their automated testing platforms. STUDY DESIGN AND METHODS: The HBV NAT yield rate was estimated by testing 10,397 Hong Kong (HK) donor samples concurrently on the PROCLEIX ULTRIO (Ultrio) assay as individual donor samples with the TIGRIS and on the cobas TaqScreen multiplex (cobas MPX) test in pools of 6 with the cobas s 201. Analytical sensitivity was assessed by probit analysis of diluted international standards and operational performance was compared. RESULTS: Each system detected two different HBV NAT yield samples for a combined rate of 0.04 percent. One additional sample was reactive on the cobas MPX test but remained unresolved. The 95 percent detection limits for HIV-1, HBV, and HCV were 42.2, 12.2, and 2.0 IU per mL, respectively, for Ultrio and 50.5, 8.4, and 6.0 IU per mL for the cobas MPX. The invalid test and failed run rates were 0.05 and 2.92 percent, respectively, for the TIGRIS and 2.39 and 5.53 percent for the cobas s 201. CONCLUSION: Clinical sensitivity for HBV in HK blood donors was equivalent, as was the analytical sensitivity for HIV-1 and HBV; however, the Ultrio assay had a higher analytical sensitivity for HCV. Despite a shorter downtime and mean time of repair for the cobas s 201, the TIGRIS demonstrated better overall operational performance.     

各类慢性乙型肝炎患者HBV前S2抗原与HBV感染血清标志物及HBVDNA的关系

目的探讨乙型肝炎病毒(HBV)前S2抗原(preS2Ag)与HBV感染5项标志物(HBV-M)、HBV DNA之间的关系及对慢性乙型肝炎分类诊断的临床意义。方法对584例各类慢性乙型肝炎患者血清采用放射免疫法(R IA)检测preS2Ag,用酶联免疫吸附试验(ELISA)检测HBV-M(HBsAg、抗HBs、HBeAg、抗HBe、抗HBc),用聚合酶链反应(PCR)检测HBV DNA。结果慢性乙型肝炎轻度、中度、重度及肝炎后肝硬化患者preS2Ag的检出率分别为45.98%、67.10%、83.87%及92.86%;preS2Ag在HBeAg阳性、HBV DNA>105拷贝/mL患者中检出率明显高于HBeAg阴性、HBV DNA<105拷贝/mL患者,差异有统计学意义(P<0.001)。结论preS2Ag的检出意味着病毒有复制或有传染性;开展preS2Ag的检测有助于慢性乙型肝炎的分类、慢性乙型肝炎急性发作和预后的判断。     

Serologic evidence of hepatitis A and B virus infections in thalassemia patients: a retrospective study

To determine the current risk of hepatitis B virus (HBV) infection in multiply transfused thalassemia patients, we tested sera from such patients in New York City for the hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs) using radioimmunoassay techniques. Altogether 48 per cent of the patients had either HBsAg (4.5%) or anti- HBs (43.9%) positive sera. The prevalence of these HBV markers was related to both the number of units transfused and the year blood transfusion therapy was begun, although evidence suggested that the latter factor had the greatest influence. Donor HBsAg screening began in New York in 1969, and only one patient first transfused since that time had HBV marker positive serum. Thus, multiply-transfused thalassemia patients now appear to be at little risk of HBV infection from transfusions. Sera were also tested for antibody to the hepatitis A virus (anti-HA) using immune adherence hemaglutination. Anti-HA prevalence was only 4.9 per cent, no greater than rates reported among nontransfused children, providing evidence against a significant role for blood transfusions in hepatitis A virus transmission.     

Prevalence and risk factors of hepatitis C virus, hepatitis B virus, and human immunodeficiency virus in multiply transfused recipients in Mexico

BACKGROUND: Transfusion-transmitted viral infection (TTI) is a major problem in patients receiving blood products. Monitoring high-risk patients is essential for assessing the epidemiology of blood-borne infections.
STUDY DESIGN AND METHODS: A 1-year, cross-sectional seroprevalence study in patients with a history of multiple transfusions was conducted. Peripheral blood samples were titered to detect serologic markers of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The presence of these viruses and demographic, behavioral, and medical traits were assessed.
RESULTS: A total of 300 male and female multiply transfused patients with a mean age of 30.7 (±17.5) years were studied. The prevalence was 13.7% for HCV, 7% for HBV, and 1.7% for HIV. Patients with hemophilia had the highest prevalence for HCV and HIV infections, and hemodialyzed patients, for HBV infection. The risk factors related to acquired HCV were hemophilia (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.5-12.6), more than five hospitalizations (OR, 3.8; 95% CI, 1.6-8.9), and having received a transfusion before mandatory screening in 1993 (OR, 8.4; 95% CI, 2.0-34.6), and for HIV, having received a transfusion before 1987 (OR, 19.0; 95% CI, 2.0-177.7). The main risk factors for HBV were having end-stage renal disease and being treated with hemodialysis (OR, 3.7; 95% CI, 1.4-9.9) and transplantation (OR, 4.2; 95% CI, 1.4-12.1).
CONCLUSIONS: This study showed that HCV infection was more frequently identified than HBV and HIV infections in multiply transfused Mexican patients. Additionally, several risk factors are associated with TTI such as mandatory screenings before 1987 and 1993, which were the most important for HIV and HCV infections but not for HBV.     

Prospective study of the evaluation of hepatitis C virus infectivity in a high-purity, solvent/detergent-treated factor VIII concentrate: parallel evaluation of other markers for lipid-enveloped and non-lipid- enveloped viruses. The Ad Hoc Study Group of the Fondazione dell'Emofilia

This prospective study was carried out with the aim of evaluating the efficacy of solvent/detergent inactivation of the hepatitis C virus (HCV) as applied to a chromatographic factor VIII concentrate. In parallel, the markers for other viruses, either lipid-enveloped (human immunodeficiency virus types 1 and 2 [HIV-1 and -2] and hepatitis B virus [HBV]) or non-lipid-enveloped viruses (such as B19 parvovirus and hepatitis A virus [HAV]) were evaluated. The study included 14 hemophilia centers, which enrolled 36 previously untreated patients (median age, 3 years; range, 1–56). The length of follow-up was 12 months, during which HCV (first- and second-generation assays and recombinant immunoblot assay), HIV-1 and -2, HBV, HAV (IgG and IgM), and parvovirus (IgG and IgM) antibodies, as well as alanine aminotransferase values were evaluated. Thirty-one patients were analyzable; none seroconverted for HCV, HBV, or HIV after exposure to a total of 165,000 IU of factor VIII (41 different lots). In one patient, alanine aminotransferase values rose to 167 mU per mL, 6 weeks after the first concentrate infusion, and this patient seroconverted for HAV 1 week later. Furthermore, 10 patients seroconverted for parvovirus during follow-up. This study suggests that the solvent/detergent method of virus inactivation is efficient in relation to lipid-enveloped blood- borne viruses but not in relation to non-lipid-enveloped viruses.     

Occult hepatitis B virus infection in Thai blood donors

BACKGROUND: An evaluation by the National Blood Center, the Thai Red Cross Society, of two commercial multiplex nucleic acid tests (NATs; the Chiron PROCLEIX ULTRIO test and the Roche Cobas TaqScreen MPX test) for screening Thai blood donors for hepatitis B virus (HBV), hepatitis C virus, and human immunodeficiency virus Type 1 identified 175 HBV NAT–reactive/hepatitis B surface antigen (HBsAg)‐negative donors. The classification of the HBV infection of these donors was confirmed by follow‐up testing. STUDY DESIGN AND METHODS: Index samples were tested for HBV serologic markers and HBV viral loads were determined. Donors were followed for up to 13 months and samples were tested with both NAT assays and for all HBV serological markers. RESULTS: Of 175 HBV NAT–yield donors, 72 (41%) were followed. Based on the follow‐up results, the majority of donors who were followed had an occult HBV infection (66.7%), followed by donors with a primary, acute infection (26.4%). The majority of donors in this latter group (20.8%) were in the window period. Three donors (4.2%), who were anti‐HBs positive, had a reinfection or breakthrough infection. CONCLUSION: The majority of donors detected during routine screening, who were HBsAg negative and NAT reactive, had an occult HBV infection, thus validating the decision to introduce NAT for blood donations in Thailand.     

Dried sera for confirming blood-borne virus infections (HCV,HTLV-I,HIV & HBsAg)*

Summary. For safe blood transfusion, developing countries face considerable problems including serological screening and confirmation of blood-borne virus infections (HCV, HTLV-I, HIV and HBsAg). Confirmation tests are not only costly but also require sophisticated techniques and expertise. In order to provide this support we have attempted to perform a virus antibody confirmation test on samples dried on blotting paper (BP). Forty-nine sera derived from selected patients and donors from Bombay, and nine donors' sera from Bellarussia were transported on BP. In control experiments, dilutions of antibody-positive sera (HIV, HTLV-I & HCV) and ‘blinded’ HTLV-I antibody-positive and antibody-negative donors were applied on BP. Eluates from snipped BP were tested initially by screening tests, and the reactives were subjected to confirmatory tests for three types of virus antibody tests (HCV, HTLV-I & HIV) by blotting methods and neutralisation tests for HBsAg. There was considerable reduction of titres in dry sera but all BP-derived dry specimens gave excellent qualitative concordance with their liquid-equivalent sera, and the HTLV-I-positive donor was identified and reconfirmed correctly. Presence of only HCV antibody was confirmed in all the nine selected Bellarussian donors. Blood donors in Bombay had 3% HIV antibody, 6% HBsAg and none had HCV antibody, while selected patients showed substantially higher levels of these markers: HIV-antibody 64%, HBsAg 57% and HCV-antibody 17% confirmed positive. The cause of this high level remains to be established. Dry samples received by post seem to be an economical approach to a first step in providing some levels of independent confirmation of reactives in developing countries.     

乙型肝炎病毒 PreS1抗原及抗体检测应用价值分析

目的：探讨乙型肝炎病毒（HBV）前S1（PreS1）抗原及抗体检测的临床应用价值。方法于2013年3～11月,随机选择具有不同乙型病毒性肝炎（简称乙肝）两对半检测结果的患者120例进行PreS1抗原及抗体检测,分析PreS1抗原及抗体检测结果与两对半检测结果的关系。结果大三阳及小三阳患者 PreS1抗原阳性检出率为89％和7％,乙肝表面抗原（HBsAg）、乙肝核心抗体（HBcAb）阳性患者阳性检出率为14％,单纯 HBsAg阳性患者阳性检出率为5％。PreS1抗原与 HBsAg、乙肝 e抗原和 HBcAb具有一定的相关性。结论两对半联合PreS1抗原、抗体检测能够更灵敏、准确地反映乙肝患者的病情和预后,在HBV感染早期诊断方面也具有一定的临床应用价值。     

140例成人人类免疫缺陷病毒感染与丙型肝炎病毒感染相互影响

目的 了解经输血或单采浆献血感染人类免疫缺陷病毒(HIV)的患者中丙型肝炎病毒(HCV)的感染率；分析HIV与HCV感染的相互影响。方法 对140例经输血或单采浆献血感染HIV的患者血清抗HCV、HBV—M、肝脏生化功能、CD4^ 和CD8^ 细胞计数、纤维胃镜、肝胆脾B超进行分析。结果 140例HIV感染和获得性免疫缺陷综合征(AIDS)患者中HCV抗体阳性者占91．5％(128／140)；HIV和HCV混合感染者肝功能损害较轻，与单纯HIV感染者比较，其肝功能、B超改变、CD4^ 细胞计数之间差异无统计学意义。结论 经输血或单采浆献血感染的HIV感染者中存在着极高的HCV感染(91．5％)。HIV和HCV混合感染者与单纯HIV感染者比较，肝功能损伤并不严重，提示HIV可能并不加速丙型肝炎的进展。     

Epidemiologic comparison of human T-lymphotropic virus type I-infected blood donors from endemic and nonendemic regions over a 3-year period

BACKGROUND: Screening for human T-lymphotropic virus type I (HTLV-I) infection became systematic in 1989 in the French West Indies for blood from all donors and in France for blood from natives of endemic areas; in 1990, it was extended to blood from donors with at-risk sex partners and in July 1991 to blood from all donors. STUDY DESIGN AND METHODS: The epidemiologic characteristics of individuals found through the screening of donated blood to be HTLV-I infected were compared for an endemic region (Guadeloupe, French West Indies) and a nonendemic region (Paris area) over a 3-year period (1989 through 1991). RESULTS: In Guadeloupe, 131 HTLV-I-infected individuals were detected in the screening of 28,801 units; in the Paris area, 38 HTLV-I-infected donors were detected in the screening of 109,824 units. All Guadeloupean HTLV- I-infected donors were natives of endemic areas. Among the 38 Parisian HTLV-I-infected donors, 21 were natives of endemic areas, 10 were natives of endemic areas and had received transfusions, 2 were whites who had received transfusions, and 5 were whites who had had heterosexual contact with natives of endemic areas. The percentage of HTLV-I-infected individuals whose blood would have been excluded because of positivity for one or more markers for other viruses did not significantly change over the study period and did not significantly differ between regions (41%). Among the eight Parisian HTLV-I-infected blood donors detected after July 1991, six would not have been detected without the biologic screening. CONCLUSION: The generalization of biologic screening of HTLV-I-infected donated blood in France was useful for the prevention of HTLV-I and HTLV type II infections through transfusion.     

乙型肝炎病毒标志物检测及流行病学意义

目的分析乙型肝炎病毒(HBV)标志物检测模式在人群中的分布并初步探询其流行病学意义。方法用酶联免疫法(ELISA)对本院2007年5月至2008年4月间免疫室12204例血液样标本进行HBV标志物测定。结果乙肝病毒表面抗原(HBsAg)阳性标本中,出现4种常见模式,以HBsAg、抗-HBe、抗-HBc3种阳性(俗称"小三阳")所占比例最大(53.9%),尤其在20岁以上年龄组中最为明显(占所有"小三阳"的92.9%)。而HBsAg阴性标本中出现6种常见模式,以5项全阴性和仅抗-HBs阳性最常见(分别占47.8%和47.9%),其余模式均占较小比率。结论"小三阳"是HBV在体内转为慢性感染较为稳定的模式,随年龄的增大这种模式所占的百分比率显著增加;各年龄组仍有相当一部分人群对HBV缺乏有效的抵抗力,急需要接种或加强接种乙肝疫苗,尤其要重视20岁以上的人群,从而有效防止HBV的传播。