闽南地区无偿献血者隐匿性乙型肝炎病毒感染研究

目的研究闽南地区无偿献血者中隐匿性乙型肝炎病毒感染(OBI)情况,探讨现有输血传播乙肝病毒(HBV)的检测方法的有效性。方法依据多种与HBV相关血清学指标的检测情况对献血者标本进行HBV携带风险评价分级,对较高携带风险的标本做单份多区段巢式-PCR检测其HBV DNA,对低携带风险的标本做10份混合的巢式-PCR检测。采用这一方案,对闽南地区19 360例HBsAg阴性的无偿献血者标本做检测分析。结果闽南地区HBsAg阴性献血者中的HBV DNA阳性检出率为0.21%(40/19 360,95%CI:0.15%—0.28%),属于OBI;其中抗-HBc阳性检出率85%(34/40),但阳性预测值仅为3.4%(34/995,95%CI:2.4%—4.7%);HBV NRAg阳性预测值30%(6/20),但灵敏度为15%(6/40)。结论现有筛查体系下无偿献血者中仍存在一定比例的OBI,需要寻求更为有效的检测方法。

Study of occult hepatitis B virus infection among blood donors in south Fujian province,China

Objective To study occult hepatitis B virus infection among blood donors in south Fujian province and discuss the effectiveness of methods to reduce transfusion transmission of hepatitis B virus.Methods Classify the HBV carrying risk of blood donors based on a variety of hepatitis B virus related serum markers detection.Samples with higher carrying risk were detected by single specimen using in-house nested PCR;samples with lower carrying risk were tested by the same method using a mini-pool of ten.A total of 19 360 HBsAg negative samples from blood donors were assayed.Results The rate of HBV DNA detection among HBsAg negative blood donors was 0.21% in south Fujian province(40/19 360,0.21%,95%CI:0.15—0.28%),which was defined as occult hepatitis B virus infection;anti-HBc assay has a higher positive detection rate(85%,34/40),but low positive predictive value(34/995,3.4%,95%CI:2.4%—4.7%);HBV NRAg assay has a higher positive predictive value(6/20,30%),but a low sensitivity(6/40,15%).Conclusion Thers is still a certain proportion of occult hepatitis B virus infection among blood donors under current blood screening system and more effective detection methods are needed.