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目的 了解深圳市在计划免疫前后出生的无偿献血者HBV感染情况,分析其血清学和分子生物学特征。方法 将本中心2016年2-6月收集的26 320人(份)无偿献血者标本,以1992年为界分为计划免疫前出生组组:19 898人(份),年龄18-<24岁;计划免疫后出生组:6 422人(份),24-55岁。分别将每组再分为HBsAg(+)/HBV DNA(+)、HBsAg(+)/HBV DNA(-)、HBsAg(-)/HBV DNA(+)和HBsAg(-)/HBV DNA可疑(NAT初筛阳性、鉴定试验阴性)4种类型,做“乙肝两对半”检测与HBV DNA小容量和大容量提取,采用巢氏PCR方法扩增BCP/PC和S区基因序列,并对所得序列做基因型分析,同时采用实时荧光定量PCR检测(qPCR)和分析。结果 本组26 320(人)份献血者标本,通过酶免方法初筛检出242例HBsAg不合格标本,经NAT、巢氏-PCR和qPCR检测HBV DNA阳性率为0.741%(195/26 320),其中195名HBV阳性者里有164(130+34)人为初次献血者。计划免疫前后出生2组中初次献血者的HBV DNA阳性率分别为1.309%(130/9 929)vs 0.707%(34/4 810)(P<0.05);隐匿性乙肝感染(OBI)阳性率分别为0.256%(51/19 898)vs 0.093%(6/6 422)(P<0.05)。在可分型的120例标本中,HBV基因型B型95例、C型25例,2种基因型在2组间(74/19 vs 21/6)的分布无明显差异(P>0.05)。结论 乙肝疫苗的接种明显降低了献血人群HBV感染的风险,有益于输血安全保障的提高。
Objective To understand the HBV infection of unpaid blood donors in Shenzhen before and after the planned immunization and analyze the serological and molecular biological characteristics. Methods A total of 26 320 blood donors collected from the center between February and June 2016 were divided into pre-immunization groups (19 898) and age 18- <24 years old ; Born after planned immunization: 6 422 persons, 24-55 years old. Each group was further divided into HBsAg (+) / HBV DNA (+), HBsAg (+) / HBV DNA (-), HBsAg (-) / HBV DNA Positive screening test, negative identification test) for the detection of hepatitis B two pairs of semi-small HBV DNA with small capacity and large capacity extraction, the use of nested PCR amplification of BCP / PC and S district gene sequence, and the resulting sequence Genotype analysis was performed using both real-time qPCR and qPCR analysis. Results A total of 26 320 (human) blood donors were enrolled in this study. A total of 242 HBsAg non-conforming samples were detected by ELISA, and the positive rate of HBV DNA was 0.741% (195/26 320) by NAT, Nestle-PCR and qPCR ) Of whom 164 (130 + 34) were first blood donors in 195 HBV-positive individuals. The positive rates of HBV DNA in the first blood donors before and after the planned immunization were 1.309% (130/9 929) vs 0.707% (34/4 810) respectively (P <0.05). The positive rates of occult hepatitis B infection Was 0.256% (51/19 898) vs 0.093% (6/6 422) (P <0.05). There were 95 cases of HBV genotype B and 25 cases of genotype C in 120 subtypes. There was no significant difference in the distribution of the two genotypes between the two groups (74/19 vs 21/6) (P> 0.05) . Conclusion Hepatitis B vaccination significantly reduces the risk of HBV infection in blood donors and is beneficial to the improvement of blood transfusion safety and security.