无偿献血人群隐匿性乙型肝炎病毒感染调查*

doi:10.3969/j.issn.1672-5069.2022.04.011

实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (4): 496-499.doi: 10.3969/j.issn.1672-5069.2022.04.011

无偿献血人群隐匿性乙型肝炎病毒感染调查^*

臧伟伟, 齐文革, 杨贺, 张玉敏

071000 河北省保定市中心血站质量管理科(臧伟伟,齐文革);河北大学附属医院检验科(杨贺);唐山市人民医院检验科(张玉敏)

收稿日期:2022-04-14 出版日期:2022-07-10 发布日期:2022-07-14
作者简介:臧伟伟,女,44岁,大学本科,主管检验师。E-mail:zangweiwei2022@126.com
基金资助:
^*河北省卫生健康委员会科研基金资助项目(编号:20201538)

Prevalence of occult hepatitis B viral infections in blood donors

Zang Weiwei, Qi Wenge, Yang He, et al

Department of Quality Management, Central Blood Station, Baoding 071000, Hebei Province, China

Received:2022-04-14 Online:2022-07-10 Published:2022-07-14

摘要/Abstract

摘要： 目的调查无偿献血人群隐匿性乙型肝炎病毒感染(OBI)情况。方法 2021年1月～2021年12月我站无偿献血者血液样本107397份,采用两种ELISA法检测试剂盒进行HBsAg的初次筛查,采用核酸检测(NAT)法对两次HBsAg结果均为阴性的样本进行HBV DNA检测。对血清HBsAg阴性而HBV DNA阳性样本进行HBV血清学标志物检测,并采用实时荧光定量聚合酶链式反应(PCR)法检测核酸和病毒基因分型。结果在筛查的107397例无偿献血人群血样本中,经血清标志物检测后确认为OBI 者29例(0.27‰);血清抗-HBc阳性者12例(35.3%),抗-HBe/抗-HBc阳性者8例(23.5%),抗-HBs/抗-HBc阳性者6例(17.7%),抗-HBs/抗-HBe/抗-HBc阳性者3例(8.8%);19～29岁年龄段献血人群OBI感染率为0.09‰,30～39岁人群为0.32‰,40～49岁人群为0.39‰,50～55岁年龄段献血人群OBI感染率为0.41‰,且该年龄段重复献血者OBI感染率为0.31‰;血清抗-HBs/抗-HBc阳性和抗-HBs/抗-HBe/抗-HBc OBI献血者血清病毒载量>1000 IU/mL的占比分别为33.3%和66.7%,显著高于血清仅抗-HBc阳性者(0.0%,P<0.05)或血清抗-HBe/抗-HBc阳性者(0.0%,P<0.05);在29例OBI献血者中,C基因型占比为62.1%,B基因型感染占比为27.6%。结论在初筛血清HBsAg 阴性的献血人群中,可能还存在很低比率的OBI人群,对用血安全提出了挑战。全面进行病毒核酸检测的花费-效益关系需要认真研究,提高常规ELISA检测方法的灵敏度也是关键。

关键词: 隐匿性乙型肝炎病毒感染, 乙型肝炎病毒表面抗原, 酶联免疫吸附法, 核酸检测, 无偿献血人群

Abstract: Objective The aim of this study was to investigate the prevalence of occult hepatitis B viral infections (OBI) in blood donors (BD). Methods 107397 blood samples were collected in our Blood Station between January and December 2021. The initial serum screening of HBsAg was conducted by two ELISA kits, and serum HBV DNA loads was assayed by NAT. For serum HBV DNA positive samples, serum HBV markers were repeatedly detected and HBV genotype was determined by real-time fluorescence quantitative polymerase chain reaction (PCR). Results Out of the 107397 blood samples, the OBI was found in 29 cases (0.27‰) as defined by serum HBV DNA positive; the re-testing of the positive blood showed that serum anti-HBc positive in 12 cases (35.3%), anti-HBe/anti-HBc positive in 8 cases (23.5%), anti-HBs/anti-HBc positive in 6 cases (17.7%) and anti-HBs/anti-HBe/anti-HBc positive in 3 cases (8.8%); the prevalence of OBI in individuals at 19-29 year old was 0.09‰, in those at 30-39 was 0.32‰, in at 40-49 was 0.39‰ and in at 50-55 was 0.41‰, and in persons at age of 50-55 with more than one time blood donor, the prevalence of OBI was 0.31‰; the percentages of serum HBV DNA loads greater than 1000 IU/mL in OBI individuals with serum anti-HBs/anti-HBc positive and with serum anti-HBs/anti-HBe/anti-HBc positive were 33.3% and 66.7%, significantly higher than 0.0% in those with serum anti-HBc positive (P<0.05) or with serum anti-HBe/anti-HBc positive (0.0%, P<0.05); out of the 29 OBI persons, the genotype C infection accounted for 62.1% and genotype B infection for 27.6%. Conclusion The prevalence of OBI in blood donors is a challenge for public health security, and the cost-efficacy of all-scale detection of serum HBV DNA loads in this setting needs further investigation. The quality and sensitivity of conventional ELISA kits should be improved.

Key words: Occult hepatitis B virus infection, Hepatitis B surface antigen, Enzyme-linked immunosorbent assay, Nucleic acid test, Blood donors

臧伟伟, 齐文革, 杨贺, 张玉敏. 无偿献血人群隐匿性乙型肝炎病毒感染调查^*[J]. 实用肝脏病杂志, 2022, 25(4): 496-499.

Zang Weiwei, Qi Wenge, Yang He, et al. Prevalence of occult hepatitis B viral infections in blood donors[J]. Journal of Practical Hepatology, 2022, 25(4): 496-499.

参考文献

[1] Wu D, Wang X, Feng F, et al. Characteristic of HBV nucleic acid amplification testing yields from blood donors in China. BMC Infect Dis, 2021,21(1):714-718.
[2] Ye X, Li T, Li R, et al. Molecular characteristics of HBV infection among blood donors tested HBsAg reactive in a single ELISA test in southern China. BMC Infect Dis, 2021,21(1):83-85.
[3] Wang T, Dai Y, Lu W, et al. An epidemiological survey of HBV infection and low-level HBsAg in military camps in eastern China. Medicine (Baltimore), 2018,97(38):e12201-e12204.
[4] Zhai X, Zhu L, Jiang J, et al. Virological activity in treatment-naïve HBeAg-negative HBV-infected adult patients: A community-based study in Jiangsu, China. Medicine (Baltimore), 2020,99(29):e21179-e21183.
[5] 孙连明.献血者健康检查相关标准和规程的理解与实施要点.中国输血杂志,2012,25(7):710-714.
[6] Mak LY, Wong DK, Pollicino T, et al. Occult hepatitis B infection and hepatocellular carcinoma: Epidemiology, virology, hepatocarcinogenesis and clinical significance. J Hepatol, 2020,73(4):952-964.
[7] Caviglia GP, Abate ML, Tandoi F, et al. Quantitation of HBV cccDNA in anti-HBc-positive liver donors by droplet digital PCR: A new tool to detect occult infection. J Hepatol, 2018,69(2):301-307.
[8] Coffie PA, Tchounga BK, Bado G, et al. Prevalence of hepatitis B and delta according to HIV-type: a multi-country cross-sectional survey in West Africa. BMC Infect Dis, 2017,17(1):466-469.
[9] 李慧文,霍宝锋,张国英,等.韶关市无偿献血人群隐匿性乙型肝炎病毒感染状况分析.临床输血与检验,2018,20(3):255-258.
[10] 董珀,何亚琴,濮云峰.常州市中心血站HBV筛查中酶联免疫检测与核酸检测结果不一致的分析.临床与病理杂志,2020,40(6):1357-1362.
[11] Raimondo G, Locarnini S, Pollicino T, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol, 2019,71(2):397-408.
[12] Hayat Davoudi G, Makvandi M, Teimoori A,et al. Frequency of OBI among patients with autoimmune hepatitis. Asian Pac J Cancer Prev, 2020,21(9):2555-2559.
[13] Ridola L, Zullo A, Laganà B, et al. Hepatitis B (HBV) reactivation in patients receiving biologic therapy for chronic inflammatory diseases in clinical practice. Ann Ist Super Sanita, 2021,57(3):244-248.
[14] Tao J, Zhang W, Yue H, et al. Prevalence of hepatitis B virus infection in Shenzhen, China, 2015-2018. Sci Rep, 2019,9(1):13948-13951.
[15] Mixson-Hayden T, Purdy MA, Ganova-Raeva L, et al. Evaluation of performance characteristics of hepatitis B e antigen serologic assays. J Clin Virol, 2018,109(1):22-28.
[16] Zhu D, Chen W, Xu C, et al. Virology and serological characteristics of chronic hepatitis B patients with the co-existence of HBsAg and anti-HBs antibodies. Clin Lab, 2020,66(11):1-3.
[17] Wang S, Tao Y, Tao Y, et al. Epidemiological study of hepatitis B and hepatitis C infections in northeastern China and the beneficial effect of the vaccination strategy for hepatitis B: a cross-sectional study. BMC Public Health, 2018,18(1):1088-1091.
[18] Kuhns MC, Holzmayer V, Anderson M, et al. Molecular and serological characterization of hepatitis B virus (HBV)-positive samples with very low or undetectable levels of HBV surface antigen.Viruses, 2021,13(10):2053-2056.
[19] Chen J, Liu B, Tang X, et al. Role of core protein mutations in the development of occult HBV infection. J Hepatol, 2021,74(6):1303-1314.
[20] Lelie N, Busch M, Kleinman S. Residual risk of transfusion-transmitted hepatitis B virus (TT-HBV) infection by NAT-screened blood components: A review of observed versus modeled infectivity from donors with window period and occult HBV infections. Transfusion, 2021,61(11):3190-3201.
[21] Jin Y, Geng N, Zhao L, et al. The prevalence of HBV infection: a retrospective study of 13 years in a public hospital of northeast China. Viral Immunol, 2020,33(2):99-104.

无偿献血人群隐匿性乙型肝炎病毒感染调查^*

Prevalence of occult hepatitis B viral infections in blood donors

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 4

编辑推荐

Metrics

本文评价

[1]	周积云,马勇,丁体龙,涂远航,陈策. 慢性乙型肝炎患者外周血CD8⁺CD28⁺T淋巴细胞百分比的变化及其临床意义探讨[J]. 实用肝脏病杂志, 2019, 22(2): 180-183.
[2]	沈显元, 陈金香, 喻春红, 卢芝君, 王丹凤. 血清HBsAg定量变化预测干扰素α-2b治疗慢性乙型肝炎停药后疗效研究^*[J]. 实用肝脏病杂志, 2016, 19(4): 476-477.
[3]	陆伟, 张占卿, 沈芳, 王雁冰, 丁荣蓉, 周新兰, 冯艳玲. 血清HBsAg和HBV DNA定量水平预测慢性乙型肝炎患者肝组织炎症活动度和纤维化程度的评价*[J]. 实用肝脏病杂志, 2016, 19(1): 20-24.
[4]	郑盛, 唐映梅, 杨晋辉. 血清HBsAg滴度监测对恩替卡韦治疗的HBeAg阳性慢性乙型肝炎患者应答反应的预测价值[J]. 实用肝脏病杂志, 2014, 17(5): 502-507.