隐匿性HBV感染献血者随访复查及归队可能性探讨
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摘要
目的了解隐匿性HBV感染献血者的转归情况及回归献血的可能性。方法对部分隐匿性HBV感染献血者进行随访,复检HBsAg、HBV DNA及抗-HBs和抗-HBc等。结果共有51名OBI献血者完成随访复检,平均年龄为41.68±7.71岁;其中34名出现HBV DNA转阴(66.7%),平均年龄(34.88±9.05)岁;17名献血者随访时持续HBV DNA阳性,平均年龄(44.88±4.81)岁,P<0.05。男性OBI献血者出现HBV DNA转阴的比例(64.3%)与女性(77.8%)的差异无统计学意义;随访前体内是否抗-HBs阳性与随访时是否HBV DNA转阴没有必然联系。所有随访的献血者HBsAg持续阴性、ALT正常且无不适症状。结论 OBI献血者在随访的病程中存在较高比例的转阴率,是否可以归队献血需要经过严格的复检。
Objective To study the outcome of blood donors with occult hepatitis B virus infection(OBI) and discuss the feasibility of their reentry to blood donation. Methods A partial of OBI blood donors from our center were tracked, and their HBsAg, HBV DNA, anti-HBs and anti-HBc was re-tested. Results A total of 51 OBI donors(median 41.68 years old) were successfully followed-up.Among them,34(median 34.87 years old) were converted to HBV DNA negative(66.7%);17 donors(median 44.88 years old) remained the same HBV DNA positive state.There was a significant difference in ages between the above groups(P<0.05). The proportion of HBV DNA converted into negative in male OBI donors(64.3%) is lower than that in female(77.8%), but with no statistically significant difference(P>0.05).Anti-HBs positive or not before follow-up has no direct correlation with the HBV DNA negative conversion. All tracked donors retained HBsAg negative with routine ALT normal, and no symptoms of discomfort were complained. Conclusion A high proportion of OBI blood donors could recover spontaneously after deferral. A strict track detection for those donors is suggested,then according to test results,donors can be either eliminated or retained.
Objective To study the outcome of blood donors with occult hepatitis B virus infection(OBI) and discuss the feasibility of their reentry to blood donation. Methods A partial of OBI blood donors from our center were tracked, and their HBsAg, HBV DNA, anti-HBs and anti-HBc was re-tested. Results A total of 51 OBI donors(median 41.68 years old) were successfully followed-up.Among them,34(median 34.87 years old) were converted to HBV DNA negative(66.7%);17 donors(median 44.88 years old) remained the same HBV DNA positive state.There was a significant difference in ages between the above groups(P<0.05). The proportion of HBV DNA converted into negative in male OBI donors(64.3%) is lower than that in female(77.8%), but with no statistically significant difference(P>0.05).Anti-HBs positive or not before follow-up has no direct correlation with the HBV DNA negative conversion. All tracked donors retained HBsAg negative with routine ALT normal, and no symptoms of discomfort were complained. Conclusion A high proportion of OBI blood donors could recover spontaneously after deferral. A strict track detection for those donors is suggested,then according to test results,donors can be either eliminated or retained.
引文
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[2] Yoshiba M,Sekiyama K,Sugata F,et al.Post-transfusion fulminant hepatitis B after screening for hepatitis B virus core antibody.Lancet,1992,339(8787):253-254.
[3] Larsen J,Hetland G,Skaug K.Posttransfusion hepatitis B transmitted by blood from a hepatitis B surface antigen-negative hepatitis B virus carrier.Transfusion,1990,30(5) :431-432.
[4] 倪修文,徐利强,李建华,等.嘉兴地区献血人群隐匿性乙肝病毒感染血清学及病毒学特征研究.中国输血杂志,2017,30(7):780-784 .
[5] 邹峥嵘,谢云峥,伍晓菲,等.上海地区无偿献血者乙型肝炎病毒隐匿性感染情况和突变分析.中国输血杂志,2013,26(8):701-704.
[6] 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.
[7] 贾晓坤,贾晓晖,杨鹏华,等.张家口地区献血者隐匿性乙肝病毒感染研究.现代生物医学进展,2013,13(10):1962-1964.
[8] 欧山海,林永财,倪宏英,等.闽南地区无偿献血者隐匿性乙型肝炎病毒感染研究.中国输血杂志,2010,23(12):1033-1037.
[9] Ye X,Li T,Xu X,et al.Characterisation and follow-up study of occult hepatitis B virus infection in anti-HBc-positive qualified blood donors in southern China.Blood Transfus,2017,15(1):6-12.
[10] Minuk GY,Kowalec K,Caouette S,et al.The prevalence and long term outcome of occult hepatitis B virus infections in community based populations.J Med Virol,2012,84(9):1369-1375.
[11] Wen X,Su H,Wang Y,et al.Prevalence and natural course of occult hepatitis B virus infection in residents of 2 communities of Wuwei City,Gansu Province,China.J Viral Hepat,2018,25(3):281-288.
[12] 欧山海,谢金镇,林永财,等.厦门地区HBsAg-/HBV DNA+献血者的流行病学调查.中国实验血液学杂志,2015,23(5):1483-1487.
[13] 杨忠思,马维娟,冯秋霞.两种核酸检测模式检测结果分析.中国输血杂志,2016,29(1):83-85.
[14] 倪宏英,欧山海,谢金镇,等.单人份核酸检测在血液筛查中的应用.中国输血杂志,2012,25(12):1272-1275.
[15] Levicnik-Stezinar S,Rahne-Potokar U,Candotti D,et al.Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients.J Hepatol,2008,48(6):1022-1025.
[16] Matsumoto C,Tadokoro K,Fujimura K,et al.Analysis of HBV infection after blood transfusion in Japan through investigation of a comprehensive donor specimen repository.Transfusion,2001,41(7):878-884.
[17] Hollinger FB.Hepatitis B virus infection and transfusion medicine:science and the occult.Transfusion,2008,48(5):1001-1026.
[18] 郭永建,姚凤兰,林授,等.HIV-1和HCV核酸检测、血液处置和献血者屏蔽与归队指引(上).中国输血杂志,2011,24(1):79-85.