检测HBV DNA评价在岗饮服人员HBV感染者的传染性

目的　检测感染HBV饮服人群的HBVDNA ,研究HBVDNA阳性者的家庭聚集性 ,探讨其传染性 ,为修订有关法规提供依据。　方法　用反向间接血凝法检测HBsAg ,用赖氏法检测ALT ,酶联免疫吸附试验检测HBVM ,聚合酶联反应 -微孔杂交法和荧光定量PCR法检测HBVDNA。对HBVDNA阳性者的家庭聚集性进行对照研究。　结果　在 4110 5名饮食服务人员中检出HBsAg阳性 14 82人 ,阳性率 3 .61%。在HBsAg <1:5 12、ALT <40、且HBeAg阴性的90 0人中检出HBVDNA阳性者 3 12人 ,阳性率 3 4.67%。HBVDNA阳性者的家庭聚集率为 86.49% ,家庭成员HBV感染率为 64 .3 8% ,相对危险性 6.5 8。HBVDNA阳性者的家庭成员HBV感染呈家庭聚集性。　结论　血清学检验结果同时表现为HBsAg <1:5 12、ALT <40、HBeAg阴性、但HBVDNA阳性的在岗饮食服务人员是HBV的危险传染源。

Application of HBV DNA Detection to Evaluate the Infectivity of Employees in Food And Public Services with HBV Infection

Objective To make the policy for control and prevention hepatitis B on the basis of HBV infection among employees on food and public services. Methods HBsAg were checked for serological marker of HBV infection by RPHA,HBVM by ELISA,HBV DNA by PCR and microcell hybridization and fluorescence-based quantitative.analysis. Familial clustering of HBV infection was analysed with the fitness comparison by binomial distribution. Result 1482 employees were HBsAg positive among.41105 employees, rate of HBsAg was 3.61%,among whom 413 employees titers of HBsAg was more than 1:512 and titers of ALT was more than 40,the rate was 23.19%, 169 employees HBeAg was positive,the rate was 16.18%, However there were 312 employees HBV DNA positive from 900 employees with HBsAg <1:512, ALT<40, and HBeAg negative, the rate was 34.67%. Familial clustering rate of HBV infection individuals was 86.49% and the rate of intrafamilial HBV infection was 64.38%.RR is 6.58. the infectivity rate of HBV in HBV DNA positive employees express Familial Clustering. Conclusion HBV DNA positive employees with HBsAg <1:512, ALT<40,and HBeAg negative,were still potential spreading sources of HBV.