核酸检测单反应性无偿献血者HBV感染状态分析

目的分析核酸检测(NAT)单反应性无偿献血者乙型肝炎病毒(HBV)感染状态。方法收集本实验室采用转录介导扩增技术(TMA)检出的NAT单反应性献血者标本,采用荧光定量聚合酶链反应(PCR)进行HBV DNA重复检测,并进行乙肝五项检测,分析HBV感染状态。结果225份TMA NAT单反应性标本中,检出78份(34.67%)TMA NAT鉴别检测和/或PCR检测HBV DNA阳性标本,其中76份可确定HBV感染状态,2份感染状态不能确定。76份标本中,63份(82.89%)为隐匿性HBV感染(OBI),13份(17.11%)为HBV疑似窗口期感染(pWP)。63份OBI标本中,49份(77.78%)标本HBV DNA水平小于20IU/mL。13份pWP标本中,4份(30.77%)标本HBV DNA水平小于20IU/mL。225份标本分为NAT检测值S/CO1~6组、6~10组、10~17组,HBV DNA确认阳性率分别为13.11%、13.64%、47.18%,S/CO 10~17组阳性率高于S/CO1~6组和6~10组(P0.05)。OBI标本中,NAT检测值S/CO 1~6、6~10、10~17的标本分别占12.70%(8/63)、4.76%(3/63)、82.54%(52/63)。13份pWP标本NAT检测值S/CO为10~17。结论部分NAT单反应性无偿献血者为HBV感染者,OBI所占比例远大于pWP感染者,且HBV DNA浓度水平极低,存在经输血传播HBV的风险。屏蔽NAT单反应性献血者对预防经输血传播HBV具有重要意义。

Detection of occult HBV infection and probably window period infection among single NAT reactive blood donors

Objective To analyze hepatitis B virus(HBV) infection stage in single nucleic acid test(NAT)reactive blood donors.Methods Blood donor samples were screened routinely for HBV DNA by using transcription-mediated amplification(TMA) NAT and quantitative polymerase chain reaction(PCR).Then serum markers of HBV were also detected.The HBV infection stage was analyzed.Results Among the 225 single NAT reactive samples,78(34.67%) were identified to be reactive for HBV DNA by TMA NAT discrimination test and/or PCR test,of which 63(82.89%) were occult HBV infection(OBI),13(17.11%) were probably window period infection(pWP),and 2 cases could not be classified for infection stage.Among the OBI samples,49 samples(77.78%) were with HBV DNA concentration less than 20 IU/mL,whereas,there were only 4 samples(30.77%) in pWP samples.The 225 samples were classified into three groups according to the S/CO of NAT, including 1-<6 group,6-<10 group and 10-17 group, the confirmed HBV DNA positive rates of which were 13.11%,13.64% and 47.18%,and the positive rate of 10-17 group was higher than 1-<6 group and 6-<10 group(P<0.05).In all 63 OBI samples,there were 8(12.70%),3(4.76%) and 52(82.54%) samples were classified into S/CO 1-<6,6-<10 and 10-17,respectively.All of the 13 pWP samples were with NAT S/CO of 10-17.Conclusion Part of single NAT reactive blood donors could be with HBV infection,of which OBI might be popular than pWP, with very low concentration of HBV DNA.Deferral of single NAT reactive blood donors could reduce transfusion-transmitted HBV infection.