单人份核酸检测在血液乙型肝炎病毒筛查中的应用

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.

Application of identification nucleic acid testing for screening of hepatitis B virus in blood samples

Objective To discuss the application value of nucleic acid testing(NAT) for virus screening in blood samples.Methods Blood samples were detected by serology method and NAT.Novartis Procleix TIGRIS system was used for NAT.Positive samples were identificated.hepatitis B virus(HBV) DNA positive samples were detected for five serum markers by using electrochemical luminescence test.Results A total of 10 127 blood samples were screened,among which 30 cases were NAT(+).12 cases of samples were NAT(+),enzyme linked immunosorbent assay(ELISA)(-),and the omission rate of ELISA was 1.18‰.After identifying,6 in 12 samples were HBV DNA(+) and ELISA(-),negative with the five serum markers or anti-HBc(+),without human immunodeficiency virus(HIV) RNA or hepatitis C virus(HCV) RNA.7 in all of blood samples were NAT(-) and ELISA(+),including 3 samples of HBsAg(+)and 4 of anti-HCV(+).Conclusion NAT could effectively decrease the risk of blood transfusion caused by omission of ELISA,while with omission too.Therefore,combined application of NAT and serology detection could be essential for screening of transfusion-transmitted virus.