首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 343 毫秒
1.
目的了解咸阳地区献血者经血传播疾病血液筛查方法的准确性与安全性,为核酸检测技术用于血站常规血液筛查提供理论依据。方法对53份抗-HCV阳性、29份抗-HIV阳性、27份HBsAg阳性标本进行NAT检测。采集自愿献血者血液标本共7981份分别使用ELISA法和实时荧光PCR法对3项经血传播疾病进行同步筛查。结果53份抗-HCV阳性标本中20份呈NAT阳性.29例抗-HIV阳性中NAT检测均为阴性.27份HBsAg阳性标本中7例呈NAT阳性。7981份标本中,HBsAg阴性HBV DNA阳性1例,HBsAg阳性HBV DNA阴性9例,二者同时呈反应性标本1例;抗-HCV阴性标本无HCV RNA阳性,抗-HCV阳性HCV RNA阴性标本26例,二者同时呈反应性标本3例;抗-HIV阳性10例,无1例HIV RNA阳性检出。结论为减少血液检测假阳性、缩短检测窗口期,有必要在本站开展血液的核酸检测。  相似文献   

2.
目的追踪随访1例抗-HCV阴性、HCV RNA阳性的献血者,观察其血清学何时发生阳性转换并确认其"窗口期"。方法采用罗氏Cobas’s201系统和科华核酸筛查系统对ELISA检测HBs Ag、抗-HCV和抗-HIV1/2为阴性的无偿献血者标本,进行HBV/HCV/HIV联合核酸定性检测。先进行混样检测,再对阳性的混合标本进行单检。对ELISA阴性、NAT阳性的献血者再进行追踪随访。结果从ELISA筛查阴性的247 936份标本中检出125例(1/1 983)NAT阳性标本,其中有1例抗-HCV阴性、HCV RNA阳性的献血者,追踪随访之后发现第6周时献血者抗-HCV完全转为阳性。结论 NAT应用于献血者血液筛查有助于缩短HCV检出"窗口期",有效地阻断了丙肝"窗口期"感染的血液传播。开展NAT在保障临床输血安全方面有重要的意义,应积极推广。  相似文献   

3.
无偿献血人群HCV感染的检测和输血残余风险分析   总被引:1,自引:1,他引:0  
目的了解深圳地区无偿献血人群HCV感染状况,评估血液经EIA筛查抗-HCV后经血传播HCV感染的残余风险。方法采用两种EIA试剂对献血者血液进行抗-HCV筛查,采用核酸检测技术检测EIA检测"合格"标本中HCV RNA,对HCVRNA阳性标本进行荧光定量PCR检测病毒载量,并对PCR扩增产物进行测序和病毒基因亚型分析。结果共筛查1997~2009年期间的献血者254 570人份,发现抗-HCV阳性1401人份,阳性率为0.55%;对2002~2007年期间EIA检测"合格"的113639份献血者血液标本进行NAT检测,检测出1份HCV RNA阳性、抗-HCV阴性的血清转换窗口期感染的献血者血液,HCV残余风险高达1/113 639。结论 EIA筛查后血液安全性有了很好的保障,但由于HCV感染窗口期存在,经血传播HCV残余风险依然处于较高的水平,NAT应用对提高血液安全,降低输血传播HCV残余风险意义重大。  相似文献   

4.
目的了解深圳地区无偿献血人群HCV感染状况,评估血液经EIA筛查抗-HCV后经血传播HCV感染的残余风险。方法采用两种EIA试剂对献血者血液进行抗-HCV筛查,采用核酸检测技术检测EIA检测"合格"标本中HCV RNA,对HCVRNA阳性标本进行荧光定量PCR检测病毒载量,并对PCR扩增产物进行测序和病毒基因亚型分析。结果共筛查1997~2009年期间的献血者254 570人份,发现抗-HCV阳性1401人份,阳性率为0.55%;对2002~2007年期间EIA检测"合格"的113639份献血者血液标本进行NAT检测,检测出1份HCV RNA阳性、抗-HCV阴性的血清转换窗口期感染的献血者血液,HCV残余风险高达1/113 639。结论 EIA筛查后血液安全性有了很好的保障,但由于HCV感染窗口期存在,经血传播HCV残余风险依然处于较高的水平,NAT应用对提高血液安全,降低输血传播HCV残余风险意义重大。  相似文献   

5.
目的评估核酸检测技术(NAT)应用于献血者血液筛查的必要性和可行性。方法采用美国罗氏诊断公司cobas s 201系统对2010年8月~2011年12月血站ELISA检测合格的献血者79 414人份血液标本进行HIVRNA-1,-2、HCV RNA和HBV DNA 3项联合核酸检测(cobas TaqScreen MPX试剂),先对6人份标本混样进行NAT,如为阴性,则直接出具结果,如出现阳性结果,再进行拆分检测;对NAT检测反应性标本进行分项确证试验。结果ELISA法共检测了98 935人份标本,抗-HIV、抗-HCV、HBsAg均为阴性的合格血液共96 923份;对79 414人份血液标本NAT共检出阳性194例,阳性率为0.24%;分项检测发现127例阳性标本,病毒类型均为HBV DNA,未检测出HCV RNA和HIV RNA,阳性检出率为65.46%(127/194)。结论 NAT能在ELISA检测阴性的献血者血液标本中筛查到HIV RNA-1,-2、HCV RNA和HBV DNA反应性标本,常规开展NAT能进一步提高血液及输血安全。  相似文献   

6.
实时荧光定量PCR筛查献血者HCVRNA的初步研究   总被引:7,自引:1,他引:7  
目的比较核酸扩增技术(NAT)和血清学酶联免疫试验(ELISA)对献血者丙型肝炎病毒(HCV)筛查的符合率。方法用实时荧光定量PCR方法对ELISA初、复检抗-HCV均为阳性的献血者血浆和抗-HCV阳性的丙型肝炎患者血浆作HCV RNA检测。结果①36例初、复检抗-HCV均为阳性的献血者血浆为HCV RNA13例阳性,答合率36.11%,31例抗-HCV阳性的丙型肝炎患者血浆的HCV RNA检测为24例阳性,符合率77.42%,两者符合率有显著性差异(χ2=11·49,P<0·005);②前述37例HCV RNA阳性血浆分别与23份初、复检抗-HCV和HCV RNA均为阴性的血浆混合后HCV RNA检测仍为阳性。且其中1例阳性血浆用上述阴性血浆100倍稀释后检测仍为阳性;③70,000例沈阳地区初、复检抗-HCV阴性献血者血浆样本NAT混合法筛查均为阴性。结论NAT可作为血清学ELISA法的补充用于对献血者血液HCV的常规筛查。  相似文献   

7.
核酸检测技术在常州地区献血筛查中的应用   总被引:4,自引:3,他引:1  
目的评估核酸检测技术(NAT)应用于献血者血液筛查必要性。方法采用罗氏诊断cobas s 201系统对2010年4月~2011年3月的血站常规EIA检测合格献血者的53 041人份标本进行H IV、HCV和HBV三项联合筛查,并对NAT筛查阳性的标本做确证试验。结果 53 041人份血液标本中,经过血清学检测,HBsAg、抗-HCV、抗-H IV ELISA检测均为阴性的合格血液共51 991份。其中,NAT共检出阳性53例,阳性检出率为0.1%,分项确证实验怀疑其中1例血液标本处于H IV病毒"窗口期",追踪检测证实其H IV呈阳性。结论 NAT系统应用于献血者血液筛查有助于缩短输血性H IV、HBV和HCV等检测的"窗口期",提高血液及输血安全。  相似文献   

8.
目的了解青岛市血液检测在新的检测模式下(血清学检测1遍+NAT 1遍)的血液检测结果。方法采用新的检测模式对2013年6月15日-12月31日在青岛市采集的55 529份无偿献血者标本用1遍ELISA血清学检测方法对HBs Ag、抗-HCV、抗-HIV进行检测,2种ELISA试剂检测抗-TP。其中54 858例ALT正常,抗-TP阴性的献血者标本进行NAT。我们将献血者血清学检测结果和NAT结果进行回顾性分析。结果 55 529例标本中共检出HBs Ag阳性128例(阳性率0.23%),抗-HCV阳性66例(阳性率0.10%),抗-HIV阳性31例(阳性率0.056%),NAT阳性率是0.21%(119例)。其中NAT阳性HBs Ag阳性53例,NAT阳性抗-HCV阳性19例,NAT阳性抗-HIV阳性8例。血清学检测结果阴性的标本中NAT阳性38例。结论血液检测新模式下,NAT和ELISA检测相互补充,有效地提高了血液安全。HBs Ag、抗-HCV和抗-HIV S/CO值与NAT结果的关联性有助于指导血液筛查和阳性献血者的追踪调查。  相似文献   

9.
目的 探讨无偿献血人群丙氨酸氨基转移酶(alanine aminotransferase,ALT)水平异常与乙型肝炎病毒感染(hepatitis B virus infection,HBI),隐匿性乙型肝炎病毒感染(occult hepatitis B virus infection,OBI),丙型肝炎病毒感染(hepatitis C virus infection,HCI),隐匿性丙型肝炎病毒感染(occult hepatitis C virus infection,OCI)的相关性。方法 分析陕西省血液中心2019 年1~6 月98 697 份血液标本ALT,HBV,HCV 检测结果;对其中ALT 单项异常标本进行核酸检测(nucleic acid testing,NAT)。此外,收集ALT 初筛不合格血样125 份,合格血样112 份,实验室检测ALT,HBsAg 和抗-HCV,分离外周血淋巴细胞(peripheral blood mononuclear cells,PBMCs)并检测HCV RNA。结果 98 697 份血液标本中ALT 水平异常者654 份,其中ALT 单项异常者641 份,ALT 合并HBsAg/ 抗-HCV 阳性8 份,仅占ALT 异常者的1.22%;HBsAg 阳性组,抗-HCV 阳性组与对应阴性组的ALT 异常率差异无统计学意义(P > 0.05);ALT 初筛不合格者HBV,HCV 感染率高于ALT 初筛合格者(4.8% vs 0.86%)和ALT 复检不合格者(4.8% vs 1.22%),差异有统计学意义(χ2=22.78,7.61,均P < 0.05);641 份ALT 单项异常者NAT 检测发现HBV DNA 阳性一例;ALT初筛不合格血样中的119 例ALT 单项异常者检出OCI 一例,112 例合格献血者未检出OCI。结论 ALT 筛查献血者OBI,HBI,HCI 及窗口期的意义并不大,ALT 对OCI 筛查有一定意义。  相似文献   

10.
核酸检测技术在献血者血液筛查中的初步应用   总被引:1,自引:1,他引:0  
目的将核酸检测(NAT)系统应用于献血者血液筛查过程。方法采用Roche Cobas S201系统对血站常规EIA检测合格献血者的65 497份标本进行HIV、HCV和HBV3项联合筛查,并对NAT筛查阳性的标本做确证试验。结果65 497份EIA检测合格标本中,NAT共检出阳性59例,阳性检出率为0.9‰;NAT筛查阳性标本经另1种核酸检测系统确证阳性率为65.38%(17/26)。结论NAT系统应用于献血者血液筛查有助于提高血液及输血安全。  相似文献   

11.
目的 通过对血液标本的核酸和血清学的检测(NAT)结果进行比较分析,从而探讨核酸检测在血液病毒筛查中的作用.方法 对血液标本进行血清学和核酸检测.使用诺华诊断血液筛查系统对标本进行单人份核酸检测.如标本核酸检测为阳性,则需要对标本进行鉴别;鉴别结果为HBV DNA标本,采用电化学发光法进一步检测乙型肝炎血清标志物五项.结果 10 127例血液标本中检测出NAT(+)标本30例,其中NAT(+)、ELISA(-)的标本12例,ELISA漏检率为1.18‰,鉴别后有6例标本为HBV DNA(+)、ELISA(-),乙型肝炎血清标志物五项为全阴性或抗-HBc(+),未检出HIV RNA或HCV RNA;另有7例标本为NAT(-)、ELISA双试剂(+),其中3例为HBsAg(+),4例为抗-HCV(+).结论 核酸检测可以有效降低酶联免疫法漏检造成的输血风险,但其也存在漏检的情况,因此核酸检测和血清学检测相结合可作为血液筛查检测中的重要手段.  相似文献   

12.

Background

In order to further improve blood safety, mini-pool (MP) nucleic acid testing (NAT) was implemented to screen samples negative for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency virus (anti-HIV), syphilis (anti-Treponemal antibody) and with normal ALT.

Study design and methods

From August 2006 to February 2008, 41,301 donations were screened using commercial HIV/HCV RNA and HBV DNA Real-Time PCR NAT assays in pools of 8. Reactive pools were re-tested as individual samples using the appropriate screening test and confirmed using an alternate commercial NAT assay. Donors reactive on both NAT assays were considered ‘confirmed’ positive for the virus concerned and recalled for additional follow-up testing and counseling.

Results

Of the 41,301 samples screened, no HIV or HCV RNA-positive/seronegative donations were detected but two HBV DNA positive/HBsAg negative blood donors (Donors 1 and 2) were identified. Their respective hepatitis immunological markers were: Donor 1 - anti-HBc positive/anti-HBe positive/HBeAg negative/ALT normal and HBV DNA viral load of 112 IU/ml; Donor 2 - anti-HBc positive/anti-HBe negative/HBeAg negative/ALT normal and HBV DNA viral load 2750 IU/ml.

Conclusions

MP NAT identified two HBsAg negative donors with presumed occult infection but no HIV or HCV seronegative/NAT positive (yield) donors. The HBV yield rate of 1 in 20,650 (95%CI - 1 in 5663 to 1 in 75,303) is comparatively high, exceeds the predicted rate based on previous modeling for the population and demonstrates the incremental blood safety value of NAT in countries where HBV is highly epidemic. The low viral load of the two yield samples underscores the importance of optimizing the sensitivity of the HBV NAT assay selected for screening.  相似文献   

13.
BACKGROUND: A multi-blood center study was conducted to evaluate a human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) multiplex nucleic acid testing (NAT) donor screening test and to determine the residual risk for HIV-1 and HCV infection. STUDY DESIGN AND METHODS: A commercially available HIV-1 and HCV assay (Procleix, Chiron Corp.) was used for simultaneous detection of HIV-1 RNA and HCV RNA on 89,647 unlinked donor samples. NAT was performed with pools of 16 samples that had passed all routine screening tests. Single-donor NAT was performed for samples that had been disqualified by any reactive screening test result(s). Anti-HCV (Ortho third-generation HCV enzyme immunoassay [EIA]), alanine aminotransferase, and HCV NAT (Roche COBAS Amplicor HCV test) confirmatory tests were used for HCV EIA-nonreactive, HCV NAT-reactive samples. RESULTS: Three HCV NAT yield cases and no HIV-1 yield cases were detected. The yield rate for HCV NAT was 3.4 per 10(5) (95 percent confidence interval [CI], 0.7-9.8). The estimated incidence rate for HCV is 24.2 per 100,000 person-years (95% CI, 3.4-88.0). If minipool NAT is added to routine donor screening, the residual risk for HCV is estimated to be reduced to 1 in 20.4x10(4) (95% CI, 1 in 5.2x10(4)-1 in 165.5x10(4)). CONCLUSION: The residual risk for transfusion-transmitted HCV infection is still relatively high in China. Incorporating NAT technology into blood donor screening would be estimated to reduce the residual risk of HCV infections eightfold over current EIA screening.  相似文献   

14.
病毒核酸检测在献血者血液筛查中的应用   总被引:15,自引:1,他引:15  
目的 建立献血者血液混合核酸检测方法 ,调查北京现有检测体系下血液的残余风险度 ,评估核酸检测 (NAT)的必要性和可行性。方法 用世界卫生组织标准品对国产丙型肝炎病毒(HCV)和人免疫缺陷病毒 (HIV)荧光 聚合酶链反应核酸扩增检测试剂进行灵敏度、重复性和精密度试验 ;对 2 0 0 2年 2~ 10月 34373份常规血清学检测 (ALT、HBsAg、抗 HCV、抗 HIV、梅毒抗体 )合格的献血者血样进行HCVRNA和HIV 1RNA核酸扩增分析。采取 2 4人份混合血样测定 ,超离心浓缩病毒 ,Roche核酸提取柱提取病毒核酸。结果 扩增系统能 10 0 %检出 5 0IU/mlHCV及 5 0IU/mlHIV 1标准品核酸 (n =16 ) ;常规血清学检测合格的献血者血液中 ,没有检出HCV或HIVNAT阳性。结论 该核酸检测体系适用于献血者血液病毒筛查 ;北京市血液的病毒安全性已有相当高的保障。为更准确地评估NAT检测项目的可行性和必要性 ,检测标本量尚待增加。  相似文献   

15.
青岛地区无偿献血者血液病毒核酸检测的研究   总被引:6,自引:1,他引:5  
目的调查青岛地区现有的血液检测体系是否存在输血传播HBV、HCV和HIV的残余风险。方法对无偿献血者样本ELISA法检测HBsAg、抗-HCV和抗-HIV的同时,应用NAT技术检测HBV、HCV和HIV。NAT检测阳性ELISA HBsAg阴性或NAT检测阴性ELISA HBsAg阳性的样本,进一步跟踪确认。结果12 000人份无偿献血者血样未发现ELISA法检测抗-HCV和抗-HIV阴性,NAT检测HCV和HIV阳性的情况,发现2例HBV DNA阳性HBsAg阴性。1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc均为阴性,跟踪11周后采血检测HBV DNA阳性,HBsAg、HBeAg和抗-HBc阳性。另1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe均为阴性,抗-HBc为阳性,跟踪3周后采血检测,2次检测结果相同,HBV DNA定量检测均为1000IU/ml左右的低含量。结论现有的血液检测体系存在输血传播HBV风险,原因可能为HBV的免疫"窗口期"、隐匿性HBV感染等,建议现有的血液检测体系下,为了阻断HBV的输血传播,增加HBV的病毒核酸检测和抗-HBc检测。  相似文献   

16.
Li L  Chen PJ  Chen MH  Chak KF  Lin KS  Tsai SJ 《Transfusion》2008,48(6):1198-1206
BACKGROUND: Blood donors in Taiwan currently are screened for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection by immunoassay. The risk of enzyme immunoassay (EIA)-negative, nucleic acid amplification technology (NAT)-reactive donations is not well understood. This study aimed to screen for such donors in Taiwan by a multiplex test (cobas TaqScreen, Roche) on a commercially available NAT system (cobas s 201 system, Roche). STUDY DESIGN AND METHODS: NAT was performed on donors without prescreening in pools of six and NAT-reactive pools were then resolved to the single donation. Individual-donor NAT-reactive samples were discriminated by a commercially available polymerase chain reaction (PCR)-based diagnostic assay (COBAS AmpliScreen, Roche). Samples with EIA- and NAT-discordant results were investigated with supplemental serologic and confirmatory tests. Each sample taken from follow-up of HBV NAT yield cases was tested for HBV serologic profile, NAT, and viral load. The sensitivity and performance efficacy were also evaluated. RESULTS: The 95 percent limit of detection (LOD) for HBV, HCV, and HIV were 5.09, 11.83, and 62.53 IU per mL, respectively. Among 10,727 seronegative donations, 12 HBV NAT yield cases (0.11%) and 1 HCV NAT yield case (0.01%) were detected. Follow-up results for 1 to 8 months showed that the HCV yield case was a window case and all HBV NAT yield cases were occult carriers. CONCLUSION: The use of NAT detected occult HBV and reduced HCV window period. The yield rate, especially occult HBV, was 10- to 100-fold higher than that in developed, HBV nonendemic countries. Therefore, NAT implementation for routine donor screening in a more cost-effective manner should contribute to safer blood transfusion in Taiwan.  相似文献   

17.
目的了解广州地区首次参加无偿献血人群HCV的感染状况。方法抗-HCV检测采用酶联免疫吸附实验(使用2种不同厂家的试剂盒),HCV RNA检测采用荧光定量PCR法,ALT检测采用速率法。结果2004—2007年在广州血液中心首次参加无偿献血的559890名献血者中,1617名经双试剂检测抗-HCV阳性,阳性率为0.289%。随机选取435名双试剂检测抗-HCV阳性血液标本进行RNA检测,266名阳性,占61.15%,男女(P<0.01)HCV RNA阳性率有统计学意义(P<0.01)。266名抗-HCV检测阳性献血者中,ALT升高(>40U)的为18名(其中男性17名),不合率为6.77%,男女ALT的不合格比有统计学意义(P<0.01)。结论随着无偿献血的开展,献血人群中HCV的阳性率不断下降;不同性别的个体清除HCV的能力不同,女性高于男性。  相似文献   

18.
19.
The risks of transmitting viral infection by blood and products derived from plasma have long been known and still remain an area of concern. Blood banks and transfusion centres are faced with the imminent introduction of nucleic acid amplification testing (NAT) of plasma pools as used by the plasma industry. In this paper, we show a part of our results of a validation study of an in-house method for routine polymerase chain reaction (PCR) screening for hepatitis C virus (HCV) RNA in plasma pools and the results of testing 2,718 anti-HCV negative plasma pools for the presence of HCV RNA. The European Committee for Proprietary Medical Products (CPMP) recommended that from 1 July 1999, only batches derived from plasma pools tested and found non-reactive for HCV RNA, using validated test methods of suitable sensitivity and specificity, should be batch released by authorities. The quality and efficiency of NAT detection of HCV RNA is among others influenced by the efficacy of RNA isolation, the primer selection and the use of control samples. Using modern molecular biology techniques (sensitive and specific in-house amplification methods for detection of HCV RNA and automated sequencing), we analysed samples of plasma pools from different Croatian transfusion centres. By detection of HCV RNA in an NIBSC working reagent (genotype 3) and a Pelispy HCV RNA run control (genotype 1) we determined a high reproducibility and sensitivity (below 100 International Units (IU)/ml) for our in-house method. By direct sequencing PCR cDNAs we proved the specificity of the test system and the possibility of determining the HCV genotype when the method was used for PCR screening of HCV RNA in single donations. Of 2,718 anti-HCV negative plasma pools we have found that 2.1$ were HCV RNA positive. Results of our investigation confirm the necessity of testing HCV RNA in plasma pools to further increase the safety of human plasma-derived drugs.  相似文献   

20.
无偿献血者血液ELISA、NAT法检测与ALT结果分析   总被引:1,自引:0,他引:1  
目的探讨无偿献血者NAT法检测和ALT筛检在血液安全中的作用。方法对无偿献血者的ELISA法、NAT法和ALT法检测结果进行分析,并对ALT异常者进行追溯性调查。结果在10 062例无偿献血者中,共检出360例ALT异常(淘汰率3.6%),其中有3例伴HBsAg和HBV DNA阳性,3例伴抗-HCV和HCV RNA阳性;检出10例HBV DNA阳性而ALT、HBsAg均正常者;未检出ALT异常伴HBV DNA或HCV RNA阳性,且ELISA法检测结果正常者。对354例单一ALT异常者的追溯性调查发现,其中35例反复献血,表现为连续或间断ALT异常。结论NAT法检测可以降低ELISA法的漏检风险,而ALT对降低输血传染病残留风险的作用仍值得探讨。  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号