保定地区无偿献血患者核酸检测HBV感染现状及影响因素分析

肝脏 ›› 2022, Vol. 27 ›› Issue (7): 762-767.

保定地区无偿献血患者核酸检测HBV感染现状及影响因素分析

何久胜, 王浩, 胡素玲

071000 保定市中心血站检验科(何久胜);保定市人民医院检验科(王浩),功能科(胡素玲)

收稿日期:2021-08-25 出版日期:2022-07-31 发布日期:2022-08-25
通讯作者: 胡素玲,Email:hsllhj2017@sina.com

Current situation and influence factors on the nucleic acid detection of HBV infection in voluntary unpaid donors in Baoding area

HE Jiu-sheng¹, WANG Hao², HU Su-ling^3*

1. Department of Laboratory Medicine, Baoding Central Blood Station, Hebei 071000, China;
2. Department of Laboratory Medicine, Baoding People’s Hospital, Hebei 071000, China;
3. Department of Function, Baoding People’s Hospital, Hebei 071000, China

Received:2021-08-25 Online:2022-07-31 Published:2022-08-25
Contact: HU Su-ling,Email:hsllhj2017@sina.com

摘要/Abstract

摘要： 目的调查保定地区无偿献血患者核酸检测HBV感染现状,并分析其影响因素。方法选取2019年1月至2020年12月保定市中心血站HBsAg快筛合格标本207 000份,均行经酶联免疫法(ELISA)、病毒核酸检测技术(NAT)检测。比较不同时间、不同人群特征HBsAg筛查阴性献血者HBV感染情况,分析HBsAg筛查阴性献血者HBV DNA阳性的影响因素。结果 HBsAg快筛合格标本207 000份,经ELISA检测HBsAg阳性949份,HBsAg筛查阴性献血者HBV DNA阳性率为0.050%(103/206 051);103例HBsAg(-)/HBV DNA(+)献血者HBV DNA定量检测结果显示,以低病毒载量为主,血清学模式以抗-HBs(+)/抗-HBe(-)/抗-HBc(-)为主。不同时间HBsAg筛查阴性献血者整体、男性、女性HBV DNA阳性率均差异无统计学意义(P>0.05);有静脉吸毒史、不安全性行为、输血史的HBsAg筛查阴性献血者HBV DNA阳性率高于无静脉吸毒史、不安全性行为、输血史者(P<0.05);logistic回归分析发现,静脉吸毒史、不安全性行为、输血史是HBV阳性的影响因素(P<0.05)。结论无偿献血者存在一定HBV阳性风险,以低病毒载量为主,在常规ELISA筛查基础上应进一步强化危险因素筛查,以降低HBV传播风险。

关键词: 血站, 核酸检测, HBV感染, Logistic回归分析

Abstract: Objective To investigate the current situation on the nucleic acid detection of hepatitis B virus (HBV) infection in voluntory unpaid blood donors in Baoding area, and to analyze the influencing factors.Methods A total of 207,000 donors with hepatitis B surface antigen (HBsAg) rapid test in our blood center from January 2019 to December 2020 were enrolled. Enzyme-linked immunoassay (ELISA) and viral nucleic acid detection technology (NAT) were performed in all cases. The clinical characteristics and influence factors of HBsAg-negative blood donors with HBV infection were compared and analyzed.Results The ELISA results of 207000 qualified samples showed that HBsAg positive in 949 cases, and the HBV DNA positive rate of HBsAg-negative cases was 0.050% (103/206051). The result of HBV DNA quantitative test in 103 HBsAg(-)/HBV DNA(+) blood donors showed that low viral load was the main reason, and the main serological model was hepatitis B surface antibody (anti-HBs) (+)/hepatitis B e antibody (antibody-HBe) (-)/hepatitis B core antibody (anti-HBc) (-). There was no significant difference in HBV infection rate among all blood donors with negative HBsAg screening at different times (P>0.05). There was also no significant difference in HBV infection rate between male and female (P>0.05). The HBV positive rate of blood donors with a history of intravenous drug use, unsafe sex, and blood transfusion was higher than those without the above-mentioned situation. (P<0.05); Logistic regression model analysis showed that the history of intravenous drug use, unsafe sex, and history of blood transfusion were influencing factors of HBV infection (P<0.05).Conclusion There is a certain rate of voluntary blood donors with HBV infection, and most of carriers with low viral load. Screening of risk factor should be further strengthened on the basis of ELISA screening to reduce the risk of HBV transmission.

Key words: Blood station, Nucleic acid detection, Hepatitis B virus infection, Logistic regression analysis

何久胜, 王浩, 胡素玲. 保定地区无偿献血患者核酸检测HBV感染现状及影响因素分析[J]. 肝脏, 2022, 27(7): 762-767.

HE Jiu-sheng, WANG Hao, HU Su-ling. Current situation and influence factors on the nucleic acid detection of HBV infection in voluntary unpaid donors in Baoding area[J]. Chinese Hepatolgy, 2022, 27(7): 762-767.

参考文献

[1] Eilard A, Andersson M,Ringlander J,et al.Vertically acquired occult hepatitis B virus infection may become overt after several years. J Infect,2019, 78(3):226-231.
[2] 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.
[3] 朱丽莉, 吕运来, 陈善华. 洛阳地区无偿献血人群中HBV DNA检测及追踪情况分析.中国输血杂志, 2020, 33(7):687-691.
[4] 朱丽敏. 核酸检测法和酶联免疫吸附法在检测血液标本内乙肝病毒的价值对比.齐齐哈尔医学院学报, 2019, 40(4):454-455.
[5] 黄爱琼. 核酸检测在献血者标本内乙肝病毒检测中的应用价值分析.中国实用医药,2020,15(14):53-54.
[6] Polaris Observatory Collaborators. Global prevalence,treatment,and prevention of hepatitis B virus infection in 2016: a modelling study.Lancet Gastroenterol Hepatol,2018,3(6):383-403.
[7] 韦丽, 李虎, 胡鹏. ALT正常的慢性HBV感染者疾病进展相关危险因素.中华肝脏病杂志, 2020, 28(12):995-998.
[8] 朱要芬, 周婉葵. 血清HBVM检测在慢性乙肝、肝硬化及原发性肝癌中的应用价值.现代临床医学, 2019, 45(3):180-182.
[9] 冯晓鸿, 陆正民, 杜合娟. 血清HBVM检测在慢性乙肝、肝硬化及原发性肝癌中的应用价值.临床输血与检验, 2017, 19(6):578-581.
[10] 叶贤林, 李懿, 李彤, 等. 计划免疫前后出生的献血者HBV DNA阳性状况及其HBV感染的血清学和分子病毒学特征分析. 中国输血杂志, 2017, 30(10):1138-1142.
[11] 周磊, 刘颖, 邓雪莲, 等. 核酸筛查中混检阳性拆分单检阴性血液标本的HBV残余风险分析.中国输血杂志, 2018, 31(9):985-988.
[12] 蒋昵真, 朱绍汶, 汤心怡 ,等. 256例ELISA筛查无反应性/核酸检测反应性标本的确认分析.中国输血杂志, 2016, 29(10):1126-1129.
[13] 张红, 杨真一, 李彤, 等. 献血者血液筛查HBsAg ELISA与NAT结果不一致标本的检测分析.中国输血杂志, 2018, 31(11):1243-1246.
[14] 邹军, 王杰, 王露楠, 等. 隐匿性乙型肝炎病毒感染及相关输血安全问题的研究进展.中华传染病杂志, 2020, 38(6):385-388.
[15] 张涛, 廖红梅, 张春红, 等. 重庆地区无偿献血人群隐匿性乙型肝炎病毒感染的特征.传染病信息, 2017, 30(1):44-47.
[16] 朱守兵, 陶建华, 刘祎, 等. 绍兴地区无偿献血者隐匿性HBV感染现状研究.中国预防医学杂志, 2019, 20(4):326-329.
[17] 钱榕, 方昌志, 熊丽红, 等. 南昌地区献血者HBV感染隐匿风险与基因型调查分析.实验与检验医学, 2014, (4):386-388,397.
[18] 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.
[19] Candotti D, Boizeau L, Laperche S.Occult hepatitis B infection and transfusion-transmission risk.Transfus Clin Biol, 2017,24(3):189-195.
[20] 费怡, 杨天, 谢震宇, 等.上海市浦东新区3～18岁人群乙型肝炎病毒感染及疫苗接种状况. 上海预防医学, 2017, 29(11):867-871.