核心抗体阳性合格献血者隐匿性乙肝病毒感染分子生物学特性及追踪结果的研究

目的了解我国核心抗体阳性合格献血者隐匿性乙肝病毒感染(OBI)情况,分析血清学和分子生物性特征。方法对HBs Ag(-)、NAT检测无反应性的合格献血者血浆,进行乙肝两对半检测和anti-HBs定量检测,对核心抗体阳性标本进行病毒核酸提取,和BCP/PC区及S区巢式PCR扩增,对扩增结果阳性产物纯化后进行基因测序及序列分析,同时进行QPCR定量检测。对HBV DNA阳性的献血者进行追踪检测和分析。结果在1 033名合格献血者中,抗-HBc(+)占47.4%,阳性率随年龄的增长而增加(P0.001),30岁以下年龄组为32.6%而到50岁以上年龄组为为69.8%。777/1033为抗-HBs(+),占75.2%。在抗-HBc(+)人群中共检出14例HBV DNA(+),其中7例抗-HBs滴度在100 IU/L以上,在抗-HBc(+)合格献血者中OBI阳性率为2.86%。8/14例OBI为B型,1例为C型。7/14能追踪的标本中,1例发现抗-HBe血清转换为阳性。所有追踪标本的病毒均变成检不出。5例BCP/PC区序列发生突变,3例S区氨基酸变异。结论经HBs Ag及NAT检测合格的抗-HBc(+)献血者,其血液中仍有一定几率含有HBV DNA,存在经输血传播病毒的威胁,提示在乙肝高流行地区需进一步提高核酸检测方法的灵敏度,必要时可增加抗-HBc的检测。     

HBsAg阴性献血者HBV DNA阳性率与HBV-M相关性分析

目的 评估乙型肝炎病毒DNA和血清标志物(HBV-M)联合检测对输血安全的价值.方法 对经常规血液筛查合格的献血者进行核酸扩增技术(NAT)检测,并对HBV DNA检测阳性标本进一步做HBV-M检测分析.结果 68 716例次常规血液筛查合格标本中,HBV DNA检测阳性率为0.12％;HBV-M各种模式中抗-HBs+、抗-HBc+模式组占22.89％;抗-HBe+、抗-HBc+模式组占19.28％;抗-HBc+模式组占18.07％;抗-HBs+、抗-HBe+、抗-HBc+模式组占13.25％;抗-HBs+模式组占10.84％;全阴模式组占15.66％.结论 HBsAg阴性抗-HBc阳性献血者血液存在输血传播HBV的风险,应用NAT检测血液HBV DNA能提高血液安全性.     

混样核酸检测HBV拆分阴性标本的血清学标志物分析

目的探讨混样核酸检测HBV拆分阴性的献血者标本是否存在低浓度HBVDNA。方法检测并比较混样核酸检测HBV拆分阴性标本与正常标本、HBVDNA拆分(+)/HBVDNA定量(-)三种标本的HBV血清学标志物(HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe)的电化学发光检测结果;对HBV拆分阴性者增加1遍拆分。结果①693例混样核酸检测HBV拆分阴性标本中:单独抗-HBs239例,抗-HBs/抗-HBc134例,抗-HBs/抗-HBe/抗-HBc111例,单独抗-HBc25例,抗-HBe/抗-HBc9例,HBV血清学标志物阳性率74.75%(518/693),虽与正常标本阳性率(71.00%)的差异无统计学意义,但抗-HBs和抗-HBs/抗-HBc模式的占比与正常标本存在差异。②275例HBVDNA拆分(+)标本中有119例HBVDNA定量检测为(-),其中抗-HBe/抗-HBc38例,抗-HBs/抗-HBc30例,抗-HBs/抗-HBe/抗-HBc22例,单独抗-HBc18例,单独抗-HBs3例,HBsAg/抗-HBe/抗-HBc4例,其HBV血清学标志物阳性率为96.64%(115/119),与混样核酸检测HBV拆分阴性标本的差异有统计学意义,但抗-HBs/抗-HBc和抗-HBs/抗-HBe/抗-HBc模式的占比与混样核酸检测HBV拆分阴性标本的差异无统计学意义。③29次2次拆分中有6次可以检出HBVDNA。结论当混样核酸检测HBV拆分阴性标本存在抗HBs伴抗HBc时,可能有HBV感染风险。     

资阳市无偿献血者乙型肝炎病毒核酸筛查阳性人群特点研究

目的研究无偿献血者乙型肝炎病毒(HBV)核酸筛查(NAT)阳性人群特点。方法选取该市2015年12月至2016年10月的无偿献血者20 000例,对其进行核酸混样定性检测、拆分单检及补充血清学检测,然后对其进行跟踪随访。结果 20000例无偿献血者中,HBV表面抗原(HBsAg)采用酶联免疫吸附试验法检测178例(0.890%)为HBsAg反应性,其中初次献血者的HBsAg反应性率明显高于重复献血者,差异有统计学意义(P0.05)。HBsAg、抗丙型肝炎病毒抗体(-HCV)、抗-人类免疫缺陷病毒(HIV1/2)结果阴性18 000例,17例(0.094%)为混合检测(MPX)反应性,其中初次献血者和重复献血者的MPX反应率之间的差异无统计学意义(P0.05)。17例MPX反应性标本中,11例(0.061%)为HBV DNA,其中初次献血者和重复献血者的HBV DNA比例之间的差异无统计学意义(P0.05)。11例HBV DNA阳性标本中,10例做乙型肝炎补充试验,乙型肝炎补充血清学试验均为阴性2例,单纯抗-HBs阳性1例,抗-HBc阳性7例,其中单纯抗-HBc阳性6例,抗-HBs阳性1例。结论无偿献血者HBV核酸筛查能够使血液安全得到进一步保证。HBV核酸检测阳性献血者中抗-HBc阳性比例较高,为降低HBV经血传播的风险,建议未开展核酸检测的血站增加对血液检测抗-HBc项目。     

HBsAg阴性、HBV DNA阳性献血者病毒感染特征研究

目的了解上海地区献血人群中血清HBsAg阴性、HBV DNA阳性感染的流行率、病毒血清学和分子生物学特点。方法选取HBsAg阴性、核酸筛查确认为HBV DNA阳性的献血者血清标本,采用酶联免疫法（ELISA）检测病毒血清标志物抗-HBc和抗-HBs;PCR扩增HBV S区基因片段,对扩增后的产物进行测序分析后,将产物序列与Genbank中HBV序列进行Blast比对,获得标本HBV毒株的基因型;采用DNAMAN软件进行蛋白表达分析,确定标本毒株的血清型,并与Genbank中野生型HBV序列进行比较,获得S区基因编码蛋白突变情况。结果上海地区HBsAg阴性献血人群HBV DNA阳性感染率约为0.045%。18例HBsAg阴性、HBV DNA阳性标本血清病毒载量均低于200IU/ml,且大部分低于20IU/ml;其中14例（77.8%）病毒血清标志物为抗-HBc和/或抗-HBs阳性。18例样本全部为B和C基因型,主要为adw和adr血清型。14例血清抗-HBc和/或抗-HBs阳性样本中,13例样本发生了S蛋白氨基酸突变,其中8例B基因型较多发生Q101K/H、M103T/I、F134L、D144A突变,5例C基因型较多发生S114T/A、T118K/R、K141T、S143T突变;4例血清阴性样本中,均未发生S区蛋白位点突变。结论上海地区献血者存在HBsAg阴性、HBV DNA阳性感染者,其血清病毒载量低,感染病毒全部为B和C基因型,主要为adw和adr血清型;其中大部分为隐匿性HBV感染,少数可能为窗口期感染;隐匿性HBV感染病毒多发生S蛋白氨基酸位点突变。     

HBsAg阴性HBV DNA阳性样本300例补充试验结果分析

目的 分析乙肝表面抗原（HBsAg）阴性乙肝病毒DNA(HBV DNA)阳性标本的补充试验结果。方法 选择2013年至2021年间的献血者样本,用酶联免疫吸附试验（ELISA）法筛查,无反应性标本用核酸检测技术（NAT）方法检测,对HBV DNA检测呈反应性的部分样本再进行乙肝五项进行补充试验。结果 对498 279份ELISA阴性的样本进行NAT检测,共检出HBV DNA阳性886例,隐匿性乙肝（OBI）检出率为1.78‰,对其中300份样本进行乙肝五项补充试验,发现抗-HBc阳性27例,抗-HBe、抗-HBc两项阳性62例,HBsAg、抗-HBe、抗-HBc阳性11例,抗-HBs、抗-HBc阳性163例,抗-HBs阳性10例,五项全阴共有27例。结论 献血者中存在血清学阳性OBI和血清学阴性OBI,补充试验对指导献血者就医,提升血站服务具有重要意义。     

单独抗-HBs阳性献血者HBV DNA阳性原因分析

目的分析乙肝血清学仅抗-HBs(+)的献血者HBV DNA(+)的原因。方法对ELISA法HBsAg(-)/HBV DNA(+)献血者标本进行化学发光法乙肝血清学(HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc)检测和HBV DNA定量检测,对乙肝血清学中仅抗-HBs阳性者进行随访。将化学发光法乙肝血清学均阴性或仅HBsAg阳性者定义为ELISA法乙肝窗口期者,同样进行随访,作为对照。结果 2010年6月—2018年5月期间共检出23例单独抗-HBs(+)且HBV DNA(+),对其中4名献血者进行了随访:有1例随访时出现抗-HBc,并且抗-HBs数值显著上升,HBV DNA检测阴性;其余3例的乙肝血清学模式不变,且抗-HBs变化不大,HBV DNA检测结果或阴或阳。作为对照的7例窗口期献血者经随访均发生乙肝血清学模式的改变,其中6例出现抗-HBs/抗-HBc,1例只出现抗-HBs;HBV DNA检测均转阴。结论单独抗-HBs(+)的献血者HBV DNA(+)可能为乙肝疫苗注射后的突破感染,也可能为隐匿性乙肝感染。     

深圳地区无偿献血HBsAg阳性感染者的血清学和分子生物学特征分析

目的了解深圳市无偿献血者乙肝病毒感染情况,分析其血清学和分子生物学特征。方法将收集到的确证HBs Ag(+)无偿献血者标本分为/NAT(+)和NAT(-)两组,进行乙肝两对半检测以及病毒核酸大容量提取,采用巢氏PCR方法扩增BCP/PC和S区基因序列,对所得的序列进行分析。结果在42 297份血液中235份HBs Ag确证为阳性的标本,HBs Ag阳性率为0.56%,其中NAT(+)162份,占总数68.9%,NAT(-)为73份,占31.1%,血清学模式以HBs Ag(+)、抗-HBe(+)、抗-HBc(+)为主,占69.78%,检出10例抗-HBc(-)标本,占总数的4.25%。在可测序166标本中,B基因型所占88%(146/166),C基因型占11.4%(19/166),D基因型在HBs Ag(+)/NAT(+)出现1例。结论 NAT检测与HBs Ag检测方法均只能检出部分乙肝感染献血者,血液检测必须结合两种检测方法来保证血液安全。数据显示有必要应用灵敏度更高的NAT检测方法。     

西安市无偿献血者隐匿性乙肝感染现状和感染因素分析

目的了解西安市无偿献血人群隐匿性乙肝(OBI)感染的流行现状、血清学模式,以及高危感染因素,降低输血传播HBV感染的风险性。方法对2012年6月—2013年12月共计263 501份献血者标本采用酶联免疫法进行血清学检测,检测后合格的血液标本进行核酸检测。对HBV DNA阳性标本测定血清学乙肝5项,统计各项检测的检出率。同时运用Logistic回归分析方法分析隐匿性乙型肝炎感染人群的易感高危因素和流行趋势。结果255 614份乙肝表面抗原阴性标本中检测出HBV DNA阳性标本171份,对这171份阳性标本进行乙肝两对半检测,157例为抗-HBs(+)或抗-HBc(+)标本,确认为OBI。因此,西安市献血者隐匿性乙型肝炎感染率为0.06%。根据血清学结果,可以分为6种模式。Logistic回归分析结果显示,年龄和是否重复献血两个因素为隐匿性乙型肝炎感染的相关危险因素。年龄>40岁及初次献血的人群感染隐匿性乙型肝炎的几率较高。结论无偿献血者存在一定比例隐匿性HBV感染,核酸检测有助于提高检出率。年龄和是否重复献血与隐匿性HBV的感染相关。     

HBsAg和抗-HBs双阳性模式分析及临床意义

目的分析乙型肝炎病毒(HBV)血清标志物乙型肝炎表面抗原(HBsAg)和乙型肝炎表面抗体(抗-HBs)同时阳性的感染模式,探讨此类模式的产生原因及其临床意义。方法应用时间分辨免疫荧光分析法定量检测10 939例血清标本,从中筛选出HBsAg和抗-HBs同时阳性的标本,进而分析其检测结果 ,并与酶联免疫吸附试验(ELISA)检测的12000例血清标本得到的HBsAg和抗-HBs同时阳性的结果进行比较。结果定量检测10939例血清标本,其中HBsAg阳性3 338例,阳性率为30.5%,HBsAg和抗-HBs同时阳性者占0.8%(28/3 338);ELISA定性检测12 000例标本,HBsAg和抗-HBs同时阳性者占0.3%(12/12 000),统计学分析两种方法在检测HBsAg和抗-HBs同时阳性的结果 ,差异有统计学意义(P0.05)。该28例表现出4种类型HBV血清学指标的组合方式,以HBsAg、乙型肝炎e抗原(HBeAg)、乙型肝炎核心抗体(抗-HBc)阳性模式和HBsAg、乙型肝炎e抗体(抗-HBe)、抗-HBc阳性模式为主,分别有8例和17例;HBsAg、抗-HBs和抗-HBc阳性模式1例;其余2例仅HB-sAg和抗-HBs双阳性。结论 HBsAg和抗-HBs同时阳性虽然少见,但具有一定的临床意义,应当引起实验室和临床的注意。     

HBV DNA PCR检测在HBsAg阴性献血人群中的应用

目的 探讨HBsAg阴性献血者HBV DNA榆测的应用价值,评估核酸检测的必要性.方法 采用PCR检测HBsAg阴性献血者HBV DNA.采用8人份混合血样测定,超离心浓缩病毒,磁珠法提取病毒核酸.如HBV DNA为阳性,则进一步检测乙型肝炎病毒血清标志物5项.结果 HBVDNA检测限量为25 U/ml,23 225份标本中有4份为HBV DNA阳性,检出率为0.17‰.进一步检测其他HBV感染的血清学指标,发现这4份标本中有2份为抗HBe和抗HBc阳性,1份为抗HBc阳性,1份为抗HBs、抗HBc阳性.对HBV DNA的定量测定表明,其含量在50～200 U/ml.结论 现行的2次酶联免疫技术的血液筛查存在HBV漏检,有必要在现有的血液筛查模式中增加抗HBc检测,或增加病毒核酸筛查.     

上海地区献血人群隐匿性HBV感染状况

目的 了解HBsAg阴性、抗-HBc阳性的献血人群中HBV DNA感染情况.方法采用酶联免疫法(ELISA)检测5 121份HBsAg阴性的合格献血者血清抗-HBc和抗-HBc阳性反应滴度;对抗-HBc阳性样本采用ELISA法检测血清抗-HBs,采用巢式PCR三区段扩增法检测HBV DNA.结果HBsAg阴性的献血人群...     

Transfusion-transmitted HBV infection in an endemic area: the necessity of more sensitive screening for HBV carriers

BACKGROUND: By NAT, HBV DNA is occasionally detectable in blood donors with past HBV infection but negative for HBsAg. Whether or not these donors can cause transfusion-transmitted HBV infections is uncertain. STUDY DESIGN AND METHODS: To determine whether or not donors with past HBV infection but negative for HbsAg can cause HBV transfusion-transmitted infections, recipients followed for blood transfusion in a university medical center in Taiwan were studied. HBV DNA and serologic markers were tested in donors and recipients. RESULTS: Of 1,038 enrolled recipients, 910 completed the 6-month post-transfusion follow-up visit. Of these, only 39 patients (4.3%) tested negative on the pretransfusion sample for HBsAg, anti-HBs, anti-HBc, and HBV DNA by PCR. These 39 HBV-naive recipients had been transfused with blood from 147 donations for which stored samples were available for HBV DNA testing by PCR; 11 of these HBsAg-negative samples tested positive for HBV DNA and anti-HBc. Two of the 11 patients who received the HBV-DNA-positive donations (18%) became positive for HBV DNA, and one seroconverted to anti-HBc and finally to anti-HBs, with a mild transient elevation of serum ALT activities. Based on the one confirmed case of HBV transmission, a projection was made that approximately 200 post-transfusion HBV infections could occur in one million units of transfused blood in Taiwan. CONCLUSIONS: In HBV-endemic areas like Taiwan, where blood donors are screened for HBsAg only, the risk of transfusion-transmitted HBV appears to be substantial. Implementation of NAT for blood screening in these settings warrants consideration.     

Hepatitis B virus DNA in blood donors with anti-HBc as a possible indicator of active hepatitis B virus infection in Yucatan, Mexico

Hepatitis B virus (HBV) may be present in serum even when negative for HBV surface antigen (HBsAg). If routine screening of sera for anti-HBV core antigen (anti-HBc) is not done, low-level HBV viraemia may not be identified. A study was done on the presence of HBV DNA in serum samples from Mexican blood donors negative for HBsAg. Sera from 158 volunteer blood donors, negative for HBsAg and anti-HBs, but positive for anti-HBc, were analysed using nested polymerase chain reaction (PCR). HBV DNA was detected in sera from 13 (8.23%) of the 158. Specificity of the PCR-amplified products was corroborated using Southern blot. Single strand conformation polymorphism (SSCP) analysis showed identical SSCP-banding patterns for all 13 PCR products, suggesting similar cDNA sequences. Occult HBV infection was observed in approximately 8% of anti-HBc only donors. The absence of HBsAg in the blood of apparently healthy individuals may not be sufficient to ensure lack of circulating HBV, and blood containing anti-HBc only may be infectious until proven otherwise.     

Hepatitis-B virus markers in patients with bleeding disorders and in healthy blood donors

Sera from 113 multiply transfused patients with bleeding disorders of whom 92 (81.4 per cent) were hemophiliacs were tested for such hepatitis-B virus (HBV) markers as HBsAg, anti-HBs. anti-HBc, e-antigen and anti-e. For comparison these marker tests were conducted on sera from 398 apparently healthy blood donors, 198 were previously known to be both HBsAg and anti-HBs negative, 126 were anti-HBs positive and 74 were HBsAg positive. Among patients with bleeding disorders, overt HBV infections were infrequent (2 per cent) and there was a low prevalence of HBsAg (3.5 per cent), e-antigen (1 per cent) and anti-e (0 per cent). However, the prevalence of anti-HBs (63 per cent) and anti-HBc (55 per cent) was high. Of the 71 anti-HBs positive patients with bleeding disorders 54 (76 per cent) were also anti-HBc positive. The sera of only four patients contained anti-HBc alone. All but one of the patients with bleeding disorders who were anti-HBc positive exhibited persistent responses. Anti-HBc was detected in all the HBsAg positive blood donors and in 113 of 126 (90 per cent) of those who were anti-HBs positive, but in none who were HBsAg and anti-HBs negative. The highest titers of anti-HBc, both among blood donors and patients with bleeding disorders occurred in those who were HBsAg positive. Among patients who were both anti-HBs and anti-HBc positive, highest anti-HBc titers occurred in those aged 31 to 40. Anti-e was detected in 59 per cent of HBsAg positive and 5 per cent of anti-HBs positive blood donors, but e-antigen was detected in none.     

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.     

Value of anti-HBc screening of blood donors for prevention of HBV infection: results of a 3-year prospective study in Northwestern Greece

BACKGROUND: The risk of infection with transfusion-transmitted viruses has been reduced remarkably. However, a zero-risk blood supply remains a popular goal. Some authorities have introduced the screening for antibody to HBc (anti-HBc) as a surrogate test for the presence of several infectious agents. A 3-year prospective study was conducted in the Epirus region of Greece to determine the prevalence of several blood-borne viruses. One component of the study was the prevalence of HBV infection markers and the potential value of anti-HBc testing of donors in this area. STUDY DESIGN AND METHODS: Between January 1, 1995, and December 31, 1997, some 6696 donors were investigated for the presence of HBV infection markers by standard EIAS: Every sample that tested HBsAg-negative but anti-HBc-reactive alone or in combination with either or both antibodies to HBV e antigen (anti-HBe) and low-titered antibodies to HBsAg (anti-HBs <20 mIU/mL) was further investigated for the presence of HBV DNA by a combination of PCR and DNA EIA. RESULTS: Of these 6696 donors, 15.8 percent tested positive for at least one serologic marker of HBV infection (HBsAg prevalence, 0.85%). Anti-HBc reactivity alone or in combination with either or both anti-HBe and low-titered anti-HBs was found in 282 donors (4.2%). None tested HBV-DNA positive. No transfusion-associated HBV infections were recorded in the recipients of the above 282 blood units. CONCLUSION: A moderate prevalence of HBV infection markers was found. However, taking into account previous studies from this region, it appears that the HBsAg prevalence has declined. In addition, the present study cannot recommend the introduction of anti-HBc screening as a surrogate marker of occult HBV infection. The adoption of this exclusion criterion in this region would result in unacceptably high rejection rates among otherwise healthy donors. The absence of any case of transfusion-associated HBV infection after the transfusion of all HBsAg-negative, anti-HBc-positive units appears to provide further support for the negative HBV DNA results. Before a consideration of screening donors, efforts must be focused on reducing the number of false-positive anti-HBc results.     

Feasibility and usefulness of an efficient anti-HBc screening programme in blood donors

SUMMARY. Post-transfusion hepatitis B remains a risk for recipients of hepatitis B surface antigen (HBsAg) screened blood. Anti-hepatitis B core antibody (anti-HBc) screening may help reduce this risk. To evaluate its usefulness, 9,238 East Anglian blood donors were screened for anti-HBc. Those with isolated anti-HBc were identified with two confirmatory anti-HBc and anti-HB surface antibody (anti-HBs) assays. The prevalence of anti-HBc reactions in screening and confirmatory assays was 1.29% and 0.35%, respectively. The level of reactivity was significantly higher when two anti-HBc assays gave concordant results or, being concordant, were anti-HBs positive. All isolated anti-HBc-positive units (0.04%) were negative for additional HBV markers including DNA tested with nested polymerase chain reaction (PCR).
A 0.31% prevalence of past HBV infection was found in this population, all carrying both anti-HBc and anti-HBs antibody, most above the protective level (0.IU/ml).
The proposed screening schemes would limit the number of deferred donors and discarded units and keep the testing time within the remit of routine blood banking practices for an additional cost of approximately £1 per unit. However, no evidence was found in this donor population to suggest that anti-HBc screening would significantly reduce the incidence of post-transfusion hepatitis B.     

乙肝核心抗体阳性供肝在肝移植中的应用

背景：现已经证实使用anti-HBc（＋）供肝会使移植后乙肝复发的风险,但anti-HBc（＋）供肝的应用明显缓解了供肝的相对匮乏。目的：分析应用anti-HBc（＋）供肝移植后乙肝复发风险及有效的预防措施。方法：应用计算机检PubMed数据库中1994-01/2009-12关于anti-HBc（＋）供肝文章,在标题和摘要中以＂Hepatitis B core antibody;donor;liver transplantation＂为检索词进行检索。选择与anti-HBc供肝相关文章。初检得到109篇文献,根据纳入标准选择48篇文章进行综述。结果与结论：HBsAg（＋）患者接受anti-HBc（＋）供肝移植术后乙肝复发率为11%,生存率为67%～100%,与HBsAg（＋）受者接受anti-HBc（-）供肝相似。HBsAg（-）受者接受anti-HBc（＋）供肝总体感染率为19%,其中未感染过乙肝受者移植术后乙肝感染率为48%,感染过乙肝受者后感染率为15%。未感染乙肝与感染过乙肝受者移植后采取有效预防措施后感染率分别为3%,12%。采用HBIG、拉米夫定、联合用药的移植后感染率分别为19%,2.6%,2.8%。提示,采用anti-HBc（＋）供肝做为供体是安全的,尤其是用在HBsAg（＋）、anti-HBc（＋）、anti-HBs（＋）受者。而HBsAg（-）受者移植后接受拉米夫定可以有效复发乙肝感染。