HBsAg初筛反应性献血者的HBV感染特征分析及其屏蔽策略

目的分析HBsAg初筛反应性献血者的HBV感染特征并探讨其屏蔽策略。方法 2016年1月—6月来本中心献血的无偿单采献血者,选取其中HBsAg初筛反应性的单采献血者为研究组,选取HBsAg初筛非反应性成功捐献单采血小板,但HBsAg酶免检测和核酸检测均阳性的单采献血者为对照组,2组血液标本进行HBsAg定量检测、HBV-DNA定量检测和HBV两对半检测。结果 80名HBsAg初筛反应性献血者的酶免检测阳性预测值为98.75%(79/80);HBsAg定量中位数为384.9 IU/mL,HBV-DNA阳性率为90%(72/80),HBV-DNA定量中位数为3.38log IU/mL,均高于对照组并具有统计学意义;HBV两对半检测"135"模式百分比、"145"模式的HBsAg定量值和HBV-DNA定量值均高于对照组并具有统计学意义。结论 HBsAg初筛反应性献血者具有较高的HBV传染性,应直接屏蔽或者按照酶免检测阳性结果进行归队管理。

Analysis on HBV infection characteristics and deferral strategy for HBsAg positive donors in preliminary screening

Objective To investigate the strategy of deferring HBsAg positive donors through analysis of HBV infection characteristics among HBsAg positive donors in preliminary screening.Methods The samples of apheresis donors in Guangzhou Blood Center from January to June 2016 were involved. 80 apheresis donors of HBsAg positive in priliminary screening were involved as the test group and another 60 apheresis donors, who were both positive in ELISA and NAT tests but negative in HBsAg priliminary screening, were involved as the control group. HBsAg virus quantitative test, HBV-DNA quantitative test were performed. Results The positive predictive value of HBsAg ELISA test for 80 donors with HBsAg positive in preliminary screening was 98.75%(79/80);the quantitative media value of HBsAg was 384.9 IU/mL, HBV-DNA positive ratio was 90%(72/80) and the quantitative media value of HBV-DNA was 3.38 logIU/mL, respectively. All of the values were higher than those in the control group and considered to be significant. HBsAg virus and HBV-DNA quantitative tests results in donors with HBsAg, HBeAg and HBCAb positive results as well as HBsAg, HBeAb and HBCAb positive results in two pairs of semi-hepatitis B test were higher than the control group and considered to be significant. Conclusion The HBsAg positive donors in preliminary screening are of high risk of infection. They are supposed to be deferred permanently.