关于中国乙型肝炎感染的建议献血者推迟策略
Ling Li1,2, Rui Wang3, Jin Guo4
1Department of Blood Transfusion, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, People's Republic of China.
Transfusion medicine (Oxford, England)
|January 23, 2024
概括
使用中和和抗HBc测定进行的确认测试可以提高乙型肝炎病毒 (HBV) 查的准确性. 这一策略通过正确识别传染性献血者,提高了献血者的安全性,使得中国的血液采集机构能够实现这一目标.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 在最初的血液测试中,B型肝炎病毒 (HBV) 的反应性可能不反映真正的感染状况.
- 准确识别感染性献血者对于输血安全至关重要.
- 目前的查方法需要改进,以提高特异性并减少不必要的捐赠者推迟.
研究的目的:
- 在献血者中评估乙型肝炎病毒 (HBV) 确认测试的疗效.
- 建立一个适当的查算法来推迟HBV-反应性献血者.
- 评估中国拟议的查战略的可行性和安全性.
主要方法:
- 乙型肝炎表面抗原 (HBsAg) 或HBV核酸试验 (NAT) 反应样本使用中和试验进行了测试.
- 通过中和呈阴性但对HBsAg有反应的样本进行了进一步的抗HBc测试.
- 接收器操作特征 (ROC) 曲线分析确定了HBsAg酶相关免疫吸收试剂 (ELISA) 试剂的最佳信号切断 (S/CO) 值.
主要成果:
- 在780个HBV反应性样本中,467个HBsAg反应性但HBVDNA阴性;其中13.92%的中和试验呈阳性.
- 在HBsAg反应,中和负样本中,30%的抗HBc检测结果呈阳性.
- 通过病毒中和呈阴性但对HBVDNA呈阳性的样本显示HBcAg阳性的高率 (>80%).
结论:
- 将HBsAg和NAT测试与HBsAg S/CO考虑和HBcAg测试相结合的选算法对于推迟HBV-反应的捐赠者是有效的.
- 这种方法提高了中国献血查的安全性和可行性.
- 实施这种算法可以提高识别感染性献血者的准确性.
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