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目的对番禺地区献血者核酸血液筛查结果进行分析,探讨核酸检测技术(NAT)在血液筛查中的意义。方法采用ELISA法对献血者标本进行两遍的HBs Ag、抗-HCV和抗-HIV三项筛查,筛查阴性样本使用罗氏诊断Cobas.S201系统开展HIV-RNA、HCV-RNA和HBV-DNA三项联合(6样本混样)检测,对混样阳性的样本进行拆分分项确证实验,对确证实验HBV-DNA阳性的样本进行乙肝两对半血清学标志物的酶免检测。结果共完成82558例标本的核酸混样检测,拆分阳性的标本154例,阳性率为0.187%(154/82558),经分项鉴定153例为HBV-DNA阳性,频率为0.185%(153/82558);1例为HCV-RNA阳性,频率为0.001%(1/82558),未发现HIV-RNA阳性样本。对153例分项鉴别实验HBV-DNA阳性的样的进行乙肝两对半血清学标志物检测,结果显示:单独HBc Ab阳性49例占比32.0%(49/153),HBc Ab阳性伴HBs Ab弱阳性48例占比31.4%(49/153),HBe Ab、HBc Ab阳性26例占比17.0%(26/153),单独HBs Ab阳性14例占比9.2%(14/153),两对半全部阴性12例占比7.8%(12/153),HBs Ab、HBe Ab、HBc Ab三项阳性的4例占比2.6%(4/153)。结论血站经ELISA法检测HBs Ag、抗-HCV和抗-HIV三项阴性的血液仍然存在一定的HBV-DNA和HCV-RNA阳性的样本,应用ELISA联合NAT进行血站血液筛查能更有效降低输血感染疾病的风险。
Objective To analyze the results of nucleic acid screening of blood donors in Panyu region and explore the significance of nucleic acid detection (NAT) in blood screening. Methods The blood samples of HBsAg, anti-HCV and anti-HIV were screened twice by ELISA, and the negative samples were screened by Roche for detection of HIV-RNA, HCV-RNA and HBV-DNA using Cobas.S201 system Three combined (6 samples mixed) detection, the mixed positive samples were split sub-confirmation test, confirming the experimental HBV-DNA positive samples for hepatitis B two pairs of semi-serological markers of enzyme-free detection. Results A total of 154,558 samples were obtained from 154 samples, of which 154 samples were positive. The positive rate was 0.187% (154/82558). The 153 samples were positive for HBV DNA with a frequency of 0.185% (153 / 82558). One patient was positive for HCV-RNA with a frequency of 0.001% (1/82558). No HIV-RNA positive samples were found. The results of two pairs of semi-serological markers of hepatitis B in 153 cases of positive HBV-DNA were as follows: 49 cases of HBc Ab alone accounted for 32.0% (49/153), HBc Ab positive with HBs Ab 48 of weakly positive cases accounted for 31.4% (49/153), HBe Ab 26 cases of positive HBc Ab accounted for 17.0% (26/153), 14 cases of positive HBs Ab alone accounted for 9.2% (14/153) 12 cases accounted for 7.8% (12/153). The positive rate of HBs Ab, HBe Ab and HBc Ab accounted for 2.6% (4/153) in 4 cases. Conclusion Blood samples from HBsAg, anti-HCV and anti-HIV three negative blood samples still have some HBV-DNA and HCV-RNA positive samples by ELISA. It is more effective to use ELISA combined with NAT for blood screening blood test Reduce the risk of blood transfusion infections.