【摘 要】
：
目的 探讨广州无偿献血人群核酸检测(nucleic acid test,NAT)反应标本中乙型肝炎病毒(hepa-titis B virus,HBV)DNA鉴别阳性标本的感染状态以及分子流行病学情况.方法 对2015年4月—2017年2月广州血液中心296 605份献血者血液样本进行常规酶联免疫吸附实验(enzyme linked immu-nosorbent assay,ELISA)和转录介导扩增技术(transcription mediated amplification,TMA)的三联核酸(trip
【机 构】
：
广州血液中心临床输血研究所广州市血液安全重点实验室,广东广州 510095
论文部分内容阅读
目的 探讨广州无偿献血人群核酸检测(nucleic acid test,NAT)反应标本中乙型肝炎病毒(hepa-titis B virus,HBV)DNA鉴别阳性标本的感染状态以及分子流行病学情况.方法 对2015年4月—2017年2月广州血液中心296 605份献血者血液样本进行常规酶联免疫吸附实验(enzyme linked immu-nosorbent assay,ELISA)和转录介导扩增技术(transcription mediated amplification,TMA)的三联核酸(triple NAT,tNAT)筛查.对单tNAT阳性、ELISA阴性且样本充足的1 303份标本进行HBV鉴别实验,阳性标本采用荧光定量聚合酶链式反应(fluorescence quantitative polymerase chain reaction,Q-PCR)和巢式聚合酶链式反应(nested polymerase chain reaction,N-PCR)检测并对Pre-S/S、BCP/PC基因进行扩增,并用HBV DNA阳性样本进行电化学发光免疫(electrochemiluminescence immunoassay,ECLIA)测定血清学标志物.结果 HBV DNA阳性标本检出381份(29.24％),随机选取187份进行Q-PCR检测和N-PCR扩增,其中44份(23.53％)为病毒载量阴性标本,143份(76.47％)为病毒载量阳性标本.另外,检测到Pre-S/S基因139份,BCP/PC基因128份.测定174份HBV DNA阳性标本,其中隐匿性HBV 感染(occult HBV infection,OBI)148份(85.06％),窗口期3份(1.72％),清除7份(4.02％),未分类16份(9.20％).通过序列对比进行基因分型,其中93份(66.91％)为HBV-B基因型,46份(33.09％)为HBV-C基因型.结论 广州地区HBV DNA鉴别阳性献血者中主要流行HBV-B基因型.tNAT反应无偿献血者中存在HBV感染者,且OBI感染者所占比例远大于窗口期感染者所占比例,因此,排除单tNAT反应献血者对预防经输血传播HBV有重要意义.
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