表征和中国南方抗-HBc阳性合格的献血者隐匿性乙肝病毒感染

StephenW

Blood Transfus. 2016 May 17:1-7. doi: 10.2450/2016.0268-15. [Epub ahead of print]
Characterisation and follow-up study of occult hepatitis B virus infection in anti-HBc-positive qualified blood donors in southern China.Ye X1, Li T1, Xu X1, Du P1, Zeng J1, Zhu W1, Yang B1, Li C2, Allain JP2,3.
Author information

• 1Shenzhen Blood Centre, Shenzhen, China.
• 2Department of Transfusion Medicine, Southern Medical University, Guangzhou, China.
• 3Department of Haematology, University of Cambridge, Cambridge, United Kingdom.
  

AbstractBACKGROUND: Most major Chinese blood centres look for hepatitis B surface antigen (HBsAg) and perform nucleic acid testing to screen blood for hepatitis B virus infection. The search for antibodies to the core of hepatitis B virus (anti-HBc) has not been implemented because it would lead to a high rate of discarded blood units. The aim of this study was to evaluate the prevalence of occult HBV infection among anti-HBc-positive qualified blood donors in southern China.
MATERIALS AND METHODS: We tested anti-HBc-positive blood donations negative for HBsAg and HBV DNA by standard NAT from Shenzhen for the presence of HBV DNA by sensitive nested and quantitative polymerase chain reactions. Anti-HBs titres were quantified. HBV DNA-positive donors were traced and followed-up.
RESULTS: Of the 1,033 qualified donors, 47.4% (95% CI: 44.4 to 50.5%) carried anti-HBc as evidence of exposure to HBV. The rate of anti-HBc positivity increased steadily with age, ranging from 32.6% in the age group <30 years to 69.8% in the age group <50 years (p<0.001). Of the 1,033 donors, 777 (75.2%; 95% CI: 72.4 to 77.8%) carried anti-HBs (>10 IU/L). HBV DNA was detected in 14 donors who were anti-HBc-positive, HBsAg-negative and negative by routine NAT. Seven of those 14 specimens had an anti-HBs titre above 100 mIU/mL. The prevalence of OBI in anti-HBc-positive qualified blood donors was 2.86% (95% CI: 1.57 to 4.75%). Eight of the 14 OBI cases were genotype B and one was genotype C; 7/14 cases were followed-up, one case converted to anti-HBe. HBV DNA became undetectable in all follow-up samples.
DISCUSSION: A small proportion of anti-HBc-positive qualified donors carry HBV DNA after HBsAg and NAT screening. This finding suggests the possibility of HBV transmission from asymptomatic donors, especially in areas of high HBV prevalence. More sensitive NAT rather than anti-HBc testing should be considered to improve blood safety.


PMID:27416568DOI:10.2450/2016.0268-15
[PubMed - as supplied by publisher]

StephenW

血Transfus。 2016年5月17日：1-7。 DOI：10.2450 / 2016.0268-15。 [打印EPUB提前]
表征和中国南方抗-HBc阳性合格的献血者隐匿性乙肝病毒感染者的随访研究。
叶X1，李T1，徐X1，杜P1，曾J1，朱W1，杨B1，C2力，阿兰JP2,3。
作者信息

    1Shenzhen血液中心，深圳，中国。
    输血医学，南方医科大学，广州，中国的教研室。
    血液学3Department，剑桥，剑桥，英国大学。

抽象
背景：

大多数主要的中国血液中心寻找乙肝表面抗原（HBsAg），进行核酸检测筛查血液中乙肝病毒感染。对于抗体乙型肝炎病毒的核心（抗-HBc）搜索尚未执行，因为它会导致废弃血液单位的高速率。这项研究的目的是评估隐匿性HBV感染的中国南方抗-HBc阳性合格的献血者中的患病率。
材料和方法：

我们测试了抗-HBc阳性献血阴性由深圳市标准NAT通过敏感的巢式和定量聚合酶链式反应存在HBV DNA的HBsAg和HBV DNA。抗-HBs抗体滴度进行定量。 HBV DNA阳性的捐助者追踪和随访。
结果：

在1033合格的捐献者，47.4％（95％CI：44.4至50.5％）进行抗-HBc如同置身于乙肝的证据。抗-HBc阳性率随着年龄的增长稳步上升，从32.6％的年龄组<30岁中69.8％的年龄组<50岁（P <0.001）英寸在1033捐助者，777（75.2％; 95％CI：72.4至77.8％）进行抗-HBs（> 10 IU / L）。 HBV DNA在14个捐助者谁是抗-HBc阳性，HBsAg阴性和负常规NAT检测。这些标本14七有一个抗-HBs滴度超过100 MIU /毫升。欧倍德在抗-HBc阳性合格的献血者的患病率为2.86％（95％CI：1.57〜4.75％）。的14 OBI案件8人B型，一个是C基因型; 7/14例，随访1例转化为抗-HBe。 HBV DNA成为所有后续样品中检测到。
讨论：

抗HBc阳性献血者合格的一小部分后进行HBsAg和NAT筛查HBV DNA。这一发现表明从无症状HBV献血者传播的可能性，特别是在高HBV流行区。更敏感的NAT，而不是抗-HBc检测应考虑提高血液安全。

结论：
    27416568
DOI：
    10.2450 / 2016.0268-15