乙肝病毒疫苗中国献血患病率较高的抗乙型肝炎核心抗原暗

StephenW

Source: Transfusion  |  Posted 1 day agoHigh prevalence of anti-hepatitis B core antigen in hepatitis B virus-vaccinated Chinese blood donors suggests insufficient protection but little threat to the blood supply;
Zheng X, Ye X, Du P, Zeng J, Zhu W, Yang B, Li C, Allain J; Transfusion (Nov 2014)

BACKGROUND In East Asia, individuals systematically vaccinated at birth to hepatitis B virus (HBV) are an increasing part of the blood donor population. Their environment presents a high risk of contact with HBV. HBV vaccine efficacy and potential safety risk carried by vaccinated donors were examined.
STUDY DESIGN AND METHODS A total of 2028 vaccinated blood donors were recruited in 2012 and 2013 and tested for serologic (hepatitis B surface antigen [HBsAg], antibody to hepatitis B surface antigen [anti-HBs], and antibody to hepatitis B core antigen [anti-HBc]) and molecular (HBV DNA) markers of HBV. HBsAg, anti-HBs, and viral load were quantified.
RESULTS Donors 18 to 21 years systematically vaccinated at birth and 22 to 25 years and older donors had both 30.0% negative serology and 1.8% anti-HBc only but the latter group carried significantly higher prevalence of anti-HBc (p < 0.0001). Anti-HBc, mostly associated with anti-HBs, increased from 10.7% at age 18 to 31.5% at age 25. The level of anti-HBs was significantly higher in anti-HBc-positive donors than in anti-HBs-only donors (p < 0.0001). Samples from 24 donors contained low viral load (25 ± 22 IU/mL), half of them undetected by standard nucleic acid testing (NAT), and were classified as four recent infections, 17 occult HBV infections (OBI), and three primary OBIs. Eighteen of 24 carried anti-HBs; 14 of 15 strains were wild-type Genotype B and one was Genotype C.
CONCLUSIONS In an environment of frequent high Genotype B or C viremia, blood donors vaccinated at birth are frequently but mildly infected: asymptomatic and normal alanine aminotransferase level, identified by anti-HBc seroconversion and boosting of anti-HBs. Low viral load and frequent anti-HBs limit transfusion risk.

StephenW

来源：输血|发表于1天前
乙肝病毒疫苗中国献血患病率较高的抗乙型肝炎核心抗原暗示的保障并不足够，但威胁不大的血液供应;
郑X，叶X，杜P，曾Ĵ，朱W，杨B，李C，阿兰D];

输血（2014年11月）
   


背景 在东亚，个人系统地接种在出生时乙肝病毒（HBV）是献血人群的增加部分。他们的环境呈现HBV接触的高危人群。乙肝疫苗的疗效和接种疫苗的捐助者携带潜在的安全风险进行了检查。

研究设计与方法 一共有2028接种献血者招募在2012年和2013年测试血清学（乙肝表面抗原[HBsAg的]，抗体乙肝表面抗原[抗-HBs]和抗体乙型肝炎核心抗原[抗-HBc]）和分子（HBV-DNA）的HBV的标志物。乙肝表面抗原，抗-HBs和病毒载量进行定量。

结果 捐助18至21岁接种系统在出生时和22至25岁及以上的捐赠者同时有30.0％的负血清学和1.8％，抗-HBc，但只有后一组抗HBc（P <0.0001）进行显著的发病率较高。抗-HBc，大多与抗-HBs相关，从10.7％上升在18岁到31.5％，在25岁抗-HBs的水平显著高于抗HBc阳性献血者相比，抗-HBs，只有捐助者（ P <0.0001）。来自24个捐助者的样本中含有低病毒载量（25±22国际单位/毫升），其中一半通过标准核酸检测（NAT）未被发现，并且被列为近四年的感染，17隐匿性HBV感染（OBI），以及三个主要OBIS 。 24十八进行抗-HBs; 15株14人野生型基因型B和一个是基因型C.

结论 在频繁的基因型B或C血症的环境中，接种在出生献血频繁，但轻度感染：无症状和正常谷丙转氨酶水平，确定了抗-HBc血清学转换，促进抗-HBs。低病毒载量和频繁的抗-HBs限制输血的风险。