输血前血液传播性疾病检测的临床分析

目的 探讨受血者在输血前进行血液传播性疾病相关检测的临床意义.方法 对2560例受血者在输血前进行乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人类免疫缺陷病毒抗体(抗-HIV)、梅毒试验(TRUST)及谷丙转氨酶(ALT)检测分析.结果 HBsAg阳性率10.10%、抗-HCV阳性率1.53%、抗-HIV阳性率0.19%、TRUST阳性率2.06%、ALT>40u/L者18,90%.结论 对受血者进行输血前五项指标检测对于预防和减少因输血引起的医疗纠纷具有重要的临床意义.     

北京某医院2012～2016年无偿献血者血液感染性指标检测结果分析

目的 了解近几年我院无偿献血者血液感染性指标的流行趋势,不断提高血液质量,降低血液报废率,确保输血安全,更好地为无偿献血招募宣传提供方向.方法 收集2012年至2016年我院无偿献血者血液感染性指标HBsAg、抗-HCV、抗-HIV、抗-TP、及ALT检测结果并进行调查分析.结果 我院近几年206962位无偿献血者中,血液感染性指标ALT、HBsAg、抗-HCV、抗-HIV、抗-TP的总体不合格率分别为5.8%、0.64%、0.45%、0.31%、0.61%.其中ALT的不合格率位居第一,其次为HBsAg和抗-TP;血液检测不合格各项目男女比较差异均有统计学意义;人群中抗-HIV阳性检出率较高,抗-HIV总体检出率为5.31/万.结论 我院无偿献血者血液中,ALT的不合格率位居第一,其次为HBsAg和抗-TP;人群中抗-HIV的阳性检出率较高,且有逐年上升趋势.应加强献血前宣传、征询和初筛工作,建立固定自愿的献血队伍,加强质量管理和规范操作,最大程度降低经血传播疾病的发生,确保临床输血安全.     

输血前血液传播性疾病检测的临床分析

目的探讨受血者在输血前进行血液传播性疾病相关检测的临床意义。方法对2560例受血者在输血前进行乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒试验（TRUST）及谷丙转氨酶（ALT）检测分析。结果 HBsAg阳性率10.10%、抗-HCV阳性率1.53%、抗-HIV阳性率0.19%、TRUST阳性率2.06%、ALT〉40u/L者18.90%。结论对受血者进行输血前五项指标检测对于预防和减少因输血引起的医疗纠纷具有重要的临床意义。     

1876名受血者输血前血液传染病指标检测分析

输血是临床上治疗和抢救病人常用的医疗措施,但因输血而引起的血液传染病感染和医疗纠纷时有发生,为了避免经血液传播疾病引起的纠纷及防止经血传播疾病的发生,我们对我院2009年（1～12）月1876名输血前的患者进行了血清ALT、HBsAg、抗-HCV、抗-HIV、梅毒抗体（TRUST）的检测,现将结果报告如下。     

受血者输血前相关传染性指标检测在医院感染控制中的意义

目的 探讨患者输血前传染性疾病相关指标检测在医院感染控制中的意义.方法 采用回顾性研究,对44968例输血前的患者进行乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人免疫缺陷病毒抗体(抗-HIV)以及梅毒螺旋体血清抗体(抗-TP)检测.结果 总阳性率为22.41％,HBsAg阳性率20.67％ (9294/44 968),抗-HCV阳性率为0.33％(148/44 968),抗-TP阳性率1.65％(9741/44 968),抗-HIV阳性39例；39例抗-HIV阳性患者23例其他三项指标至少有一项阳性,其中合并感染梅毒最多有14例；乙肝、丙肝和(或)梅毒重叠感染者共117例,同时感染乙肝加丙肝或同时感染乙肝加梅毒较常见；消化科为乙肝的高发科室(x2≥83.0,P＜0.01).结论 部分受血者在入院前就已感染了传染性疾病,输血前检测传染性指标可事先知悉患者的感染情况,对医院感染控制、日后减少医患纠纷具有重要的意义.     

受血者输血前传染病检测的临床意义

目的评价受血者在输血前传染病检测的临床意义。方法对2166例输血者在输血前进行谷丙转氨酶（ALT）、乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人央免疫缺陷病毒抗体（抗张鑫强2 ）和梅毒抗体检查。结果HBsAg阳性、抗-HCV阳性的百分率分别为13．8％和3．0％。单独ALT〉40u／L者115人次，未检出抗-HIV阳性和梅毒抗体阳性。结论对受血者在输血前传染病检测具有重要的临床意义。     

ALT单项不合格献血者再次献血血液筛查结果追踪调查分析

目的探讨和评价ALT血液筛查项目在临床用血血液安全中的意义。方法采用回顾性调查法对2010年10月至2012年12月期间,ALT单项阳性并再次献血的献血者血液筛查结果进行追踪调查和分析。结果 3910例再次献血者中,HBsAg、抗-HCV、抗-HIV、抗-TP以及ALT血液筛查结果均合格3053例,占再次献血的78.1%,ALT单项仍为阳性845例,占不合格的98.6%（845/857）,ALT阴性而ELISA筛查项目阳性9例,核酸筛查阳性3例,其中ALT合并NAT阳性1例。结论 ALT血液筛查在肝炎病毒感染＂窗口期＂或隐匿性感染中有提示的作用,在一定程度上能减少漏检的发生,在保障血液安全中具有一定的意义。     

患者输血前血源性传染病标志物检测的意义

输血在临床急救和治疗中发挥了巨大的作用,但由此而引发的血源性传播疾病和医疗纠纷也时有发生。为了解患者输血前经血液传播性疾病感染的情况,笔者对本院1401例患者输血前血液传染性指标进行了检测分析,现报告如下。1材料和方法1.1对象2004年3月～2004年12月在我院住院需输注全血、成份血及血制品的1401例患者进行了ALT、HBsAg、抗-HCV、抗-HIV、梅毒(TRUST)检测。男性984例,女性417例,年龄3d～89岁。1.2试剂HBsAg为上海实业科华生物技术有限公司产品。抗-HCV、抗-HIV为厦门英科新创科技有限公司产品。梅毒(TRUST)试剂为上海…     

1026例输血前患者血HBsAg、抗HCV、抗HIV和梅毒抗体检测结果分析

目的分析输血前患者传染病感染情况。方法选择本院海南分院2013年1月至12月共1026例输血前患者,对乙肝表面抗原(HBsAg)、丙肝抗体(抗HCV)、艾滋病抗体(抗HIV)和梅毒抗体检测结果进行分析。结果 HBsAg阳性者102例,阳性率为9.94%;抗HCV阳性者18例;阳性率为1.75%;抗HIV阳性者2例,阳性率为0.19%;梅毒抗体阳性者23例,阳性率为2.24%。感染指标阳性率在临床科室分布方面的差异具有统计学意义(P<0.05)。结论输血患者在输血前,传染病有一定的感染率,尤其是乙肝感染率很高。因此,输血前进行传染病检测很有必要,可减少或避免医院感染以及医疗纠纷的发生。     

2450例患者输血前感染性指标检测结果分析

目的 检测与分析患者输血前的感染性指标水平,为临床血液传染病的预防控制提供参考.方法 选取2013年6月至2016年1月期间我院收治的2450例拟接受输血的患者作为研究对象,采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)测定患者输血前的感染性指标检测,包括乙型肝炎五项标志物、抗丙型肝炎病毒抗体(hepatitis c virus antibody,抗-HCV)、抗人类免疫缺陷病毒抗体(human immunodeficiency virus antibody,抗-HIV)以及抗梅毒螺旋体抗体(treponema pallidum antibody,抗-TP),结果 2450例患者输血前感染性指标检测中,乙肝表面抗体(hepatitis B surface antibody,HBsAb)的阳性率最高,为23.18%,其次为乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg),阳性率为11.27%;患者存在2~3重感染模式,其中以乙型肝炎E抗体(hepatitis B e antibody,HBeAb)+HBsAb模式的阳性率最高,为1.18%,其次是HBsAg+HBsAb+乙肝表面核心抗体(hepatitis B core antibody,HBcAb)模式的,为1.06%;男性患者乙型肝炎e抗原(hepatitis B e antigen,HBeAg)、HBeAb、HBsAg、HBsAb、HBcAb、抗-HCV、抗-HIV和抗-TP阳性率均高于女性患者的,但差异无统计学意义;年龄>60岁患者的HBeAg、HBeAb、HBsAg、抗-HCV和抗-TP阳性率明显低于年龄<30岁和年龄为30~60岁患者(P<0.05).而各年龄段间的HBsAb、HBcAb和抗-HIV阳性率比较,差异无统计学意义(P>0.05).结论 输血患者输血前感染性指标的检测均具有一定比例的阳性检出率.加强输血前感染性指标的检测,可保证临床用血安全,减少医疗纠纷.     

Seroprevalence of HIV,HBV, HCV,and HTLV among Pregnant Women in Southwestern Nigeria

Sexually transmitted infections (STIs) are major public health challenge especially in developing countries. This study was designed to determine the prevalence of Hepatitis B virus (HBV), Hepatitis C Virus (HCV), Human immunodeficiency virus (HIV), and Human T-cell lymphotropic Virus type I (HTLV-I) among pregnant women attending antenatal clinic, in Ladoke Akintola University Teaching Hospital, Osogbo, and South-Western Nigeria. One hundred and eighty two randomly selected pregnant women were screened for HBsAg, anti-HCV, anti-HIV and HTLV-1 IgM antibodies using commercially available ELISA kit. Of the182 blood samples of pregnant women screened whose age ranged from 15–49 years, 13 (7.1%), 5 (2.7%), 9 (4.9%), and 44 (24.2%) were positive for HBsAg, anti-HCV, anti-HIV, and HTLV-1 IgM antibodies, respectively. The co-infection rate of 0.5% was obtained for HBV/HCV, HBV/HIV, HIV/HTLV-1, and HCV/HTLV-1 while 1.1% and 0% was recorded for HBV/HTLV-1 and HCV/HIV co-infections, respectively. Expected risk factors such as history of surgery, circumcision, tattooing and incision showed no significant association with any of the viral STIs (P > 0.05). This study shows that there is the need for a comprehensive screening of all pregnant women for HBsAg, anti-HCV, anti-HIV and HTLV-1 to prevent mother to child transmission of these viral infections and its attending consequences.     

Seroprevalence of HBsAg, anti-HCV, and anti-HIV among haemophiliac patients in Shiraz, Iran

A study was performed during 1999-2000 on multi-transfused patients with haemophilia who are registered by the Shiraz Haemophilia Society. HBsAg, anti-HCV, and anti-HIV were checked using a second-generation enzyme-linked immunosorbent assay (ELISA). Positive tests for anti-HCV and anti-HIV were confirmed by a western blot test. Healthy blood donors were used for the control group. HBsAg, anti-HCV, and anti-HIV were positive in two (0.71%, 95% CI = 0.12-2.33), 44 (15.65%, 95% CI = 11.76-20.26), and one (0.36%, 95% CI = 0.02-1.74) of the patients, respectively. Positive sera for HBsAg, anti-HCV, and anti-HIV were found in 85 (1.07%), 47 (0.59%), and 27 (0.34%) of the control group, respectively. The rate of anti-HCV was significantly higher in the patients than in the control group (p < 0.0001). The rate of positive anti-HCV was significantly higher than that of positive HBsAg in the patients (p < 0.0001). The reverse was correct for the control group (p = 0.0008). It is concluded that HCV is the current major problem in multi-transfused haemophiliac patients and more careful pre-transfusion screening of blood for anti-HCV must be introduced in all blood banks.     

Prevalence of hepatitis C in South Africa: detection of anti-HCV in recent and stored serum

The prevalence of anti-HCV was studied in a cohort of 2,072 South Africans. The results were compared in selected recently collected sera and in stored sera. The serum ALT and anti-HBc were also studied as surrogate markers in this population. The following groups were tested: (a) 498 urban, black blood donors (b) 500 white blood donors (c) 500 Asian blood donors (d) 216 rural hospitalized patients (e) 358 rural mineworkers. Sera found positive by the original ELISA were retested, and reproducibly positive tests in rural black men (group d) were confirmed both by recombinant immunoblot assay and by a second ELISA. An anti-HCV prevalence of 1.2%, 0.8%, and 0.6% in urban blacks, Asians, and whites was found. Antibodies to hepatitis B core antigen were found in 42.9%, 3.4%, and 1.2% of black, Asian, and white donors, respectively; 76% of donors positive for anti-HCV were anti-HBc negative. In rural African men, 17% of stored serum samples and 9.2% of recently collected serum samples were positive for anti-HCV. In this cohort 3.84% were positive by all three assays. These results suggest that the prevalence of anti-HCV in low and high-risk South African urban blood donors is comparable to high and low prevalence areas in Europe, the United States, and Japan, but indicates a relatively high degree of exposure to hepatitis C in rural African men. The reactivity of stored, frozen sera in this population requires further investigation. In South African urban blood donors, surrogate marker testing will not expedite HCV screening.     

Coxsackie B virus infections in women with miscarriage

Serum samples from 1,765 consecutive Sardinian blood donors, negative for hepatitis B surface antigen (HBsAg) and for antibodies to human immunodeficiency virus (HIV) (anti-HIV), were evaluated for the presence of antibodies to hepatitis C virus (anti-HCV) by second-generation ELISA. Anti-HCV was detected in 25 (1.45%) of the 1,765 donors examined. Anti-HCV was found in 15 of the 1,690 (0.9%) donors with normal alanine aminotransferase (ALT) and in 10 of the 75 (13%) donors with elevated ALT (P < 0.0001). Of the 15 anti-HCV-positive donors with normal ALT, only five (33%) were confirmed to be positive by second-generation RIBA, six (40%) were indeterminate, while four (27%) were RIBA negative. HCV RNA, as detected by polymerase chain reaction (PCR) using a set of primers from the 5′-noncoding region, was found in six of the 15 (40%) donors with normal ALT, including five RIBA, positive and one indeterminant. Of the 10 anti-HCV-positive donors with elevated ALT, all were RIBA positive and eight (80%) had detectable HCV RNA. Thus, among ELISA-reactive donors, those with elevated ALT had a significantly higher probability of being positive for secondgeneration RIBA and HCV RNA compared to those with normal ALT levels (P = 0.028). None of the 65 donors with elevated ALT but negative for anti-HCV by ELISA had detectable serum HCV RNA, as compared to eight of 10 anti-HCV ELISApositive donors (P < 0.0001). However, although negative for HBsAg, 12 of the 65 (18%) had serum HBV DNA by PCR. This study demonstrates that the combined use of second-generation ELISA and RIBA anti-HCV assays is highly effective in identifying HCV infection, whereas the specificity of ELISA alone for the screening of blood donors with normal ALT values appears to be limited. In contrast, in donors with elevated ALT levels, there is a positive correlation between second-generation assays (ELISA and RIBA) and HCV viremia. The high proportion of inapparent HBV infection in blood donors with elevated ALT levels underlines the importance of this test for the prevention of transfusion-associated viral hepatitis.     

Virological and clinical aspects of HBV-HCV coinfection in HIV positive patients

In a long-term follow-up study the clinical and virological presentation of HBV/HCV coinfection in anti-HIV positive patients was evaluated. Plasma HBV-DNA, HCV-RNA, and HIV-RNA were determined by PCR in 5 HBsAg/anti-HCV/anti-HIV positive patients, in 4 HBsAg/anti-HIV positive patients and in 82 anti-HCV/anti-HIV positive patients first observed at a Unit of Infectious Diseases in Naples (Italy) from 1990 to 2000 (follow up 6-16 years). All five hepatitis B and C coinfected patients showed reciprocal inhibition of viral replication on admission and during the follow up. At the end of the follow up a clearance of HBsAg from serum was observed in four patients and a clearance of anti-HCV in one of them. In two patients after clearance of HBsAg, evidence of occult HBV infection was observed, at times associated with a hepatic flare. None of the four patients with HIV/HBV coinfection lost HBsAg and none of the 82 with HIV/HCV coinfection lost anti-HCV during the follow up. In anti-HIV positive patients HBV/HCV coinfection is characterized by reciprocal inhibition of viral replication, more evident in HBV expression in plasma and at times by progression to occult HBV infection.     

Serum hepatitis C virus (HCV)-RNA and response to alpha-interferon in anti-HCV positive chronic hepatitis.

Hepatitis C virus (HCV) replication was assessed before and during alpha-interferon (IFN) treatment in 22 anti-HCV positive patients with posttransfusion or sporadic chronic hepatitis (CH). Eleven patients were "responders" and 11 patients "non-responders" to IFN. Thirteen anti-HCV negative healthy subjects and five anti-HCV negative patients with autoimmune CH served as controls. Serum HCV-RNA was detected by the polymerase chain reaction (PCR) in all untreated anti-HCV positive patients but in none of the anti-HCV negative subjects. PCR primers from the 5'-noncoding (NC) region were more sensitive than primers from a non-structural (NS5) region in detecting HCV-RNA (21/22, 95% vs. 7/22, 32%, respectively). Positive strand HCV-RNA titre and positivity rate for the negative strand were similar in responders and non-responders before IFN treatment, as well as anti-c100-3 titre by enzyme-linked immunosorbent assay (ELISA), and anti-5-1-1, anti-c33c, anti-c22 positivity rate by immunoblot assay (RIBA). HCV-RNA positivity by both NC and NS primers was more frequent before IFN among responders. During IFN treatment, serum HCV-RNA was detectable, mostly at low titres, in 1 (NC positive) of the 11 responders and in 9 (4 NS positive and 5 NC positive) of the 11 non-responders. Among the four non-responders who were NS positive during IFN, three were NC positive before IFN. Serum HCV-RNA was always found in our post-transfusion or sporadic anti-HCV positive patients with CH. Viraemia generally decreased during IFN treatment, but no available HCV markers clearly distinguished responders from non-responders before IFN treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prevalence of hepatitis C virus antibodies and hepatitis C virus-RNA in an urban population.

Several studies had been carried out on anti-hepatitis C virus (HCV) prevalence in populations with blood exposure risks and in blood donors. New tests are now available which allow the investigation to extend to other parameters such as antibody type and HCV-RNA. In this study the prevalence of anti-HCV c100-3 and the associated epidemiological, clinical, and virological markers were evaluated in subjects from an urban population located in central Italy. In positive cases the time persistence of HCV-RNA and anti-HCV antibody pattern was studied. For this purpose, sera from 1,484 randomly sampled individuals, aged 30-69 years, collected in 1985 and stored at -80 degrees C were retrospectively tested. The prevalence was 0.87% (i.e., 13 anti-HCV c100-3 positive cases). A significant association was observed with raised alanine transaminase (ALT) levels (P less than 0.001). Paired serum samples from 11 out of the 13 subjects collected in 1985 and 1991 were tested by nested polymerase chain reaction (PCR) using primers from the 5' non-coding region and by 4-RIBA. Concordant RIBA patterns between 1985 and 1991 were observed in the majority of positive paired sera (7/9) as well as for HCV-RNA (6/9). HCV-RNA was present in sera simultaneously positive to both types of antibody or to anti-c100-3 or anti-c22 alone. A wide spectrum of viral and antibody patterns in anti-HCV c100-3 positive sera was observed in this urban population and persisted for at least 6 years.     

Detection of hepatitis B virus DNA in blood units with anti-HBc as the only positive serological marker

Serum samples from 10,629 blood donors were screened for hepatitis B virus (HBV) serological markers (HBsAg, anti-HBs, anti-HBc, anti-HBc IgM), anti-HCV, anti-HIV1/2 and ALT. Seventy five (0.7%) blood donors were found HBsAg-positive, 1,543 (14.5%) were carrying both anti-HBc and anti-HBs. whereas 507 (4.8%) samples were positive only for anti-HBc. Among the group of 507 anti-HBc positive samples, 303 were obtained from regular volunteer blood donors who were studied in two separate time intervals of at least 6 months' duration, and 204 were from first-time blood donors. The possibility of post-transfusion hepatitis B after donation of these 507 blood units was studied by determining the presence of HBV DNA as a marker of viral replication and infectivity. HBV DNA was detected by two methods (i) a chemiluminescent molecular hybridization assay, (ii) polymerase chain reaction (PCR) followed by DNA enzyme immunoassay (DEIA). Six out of 507 samples exhibited HBV DNA results in the gray zone of the hybridization assay, but were confirmed as negative by PCR DEIA. The other 501 samples were HBV DNA-negative by both methods, although 36 of them had increased ALT levels. No cases of post-transfusion hepatitis B were reported during the year in which these 501 blood units were provided. These results show that blood units which were positive only for anti-HBc, with normal ALT and were HBV DNA-negative may be considered not infectious for hepatitis B. Gray zone results of HBV DNA using hybridization quantitative assay must be confirmed as positive or negative by a more sensitive method such as PCR. Blood units which are anti-HBc-positive, with increased ALT levels and are HBV DNA-negative, which appear to not be related to HBV replication and infectivity, may be not safe for donation because of the potential existence of other as yet unknown, hepatotropic viruses.