血液捐献查乙型肝炎病毒核心抗体:确认性检测的重要性以及对罕见的献血群体的初始影响
Michael X Fu1, Jennifer Ingram2, Courtney Roberts3
1Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Vox sanguinis
|February 29, 2024
概括
在献血者中,对乙型肝炎病毒 (HBV) 核心抗体 (anti-HBc) 的确认测试可以识别真正的感染,同时保留罕见的血液类型. 这种方法平衡了输血安全与捐献者群的多样性.
科学领域:
- 输血医学 输血医学
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 排除具有乙型肝炎病毒 (HBV) 核心抗体 (抗HBc) 的献血者,可以预防输血传播的HBV感染.
- 孤立的抗HBc阳性并不总是表明真正的过去HBV感染,导致潜在的捐赠者损失.
- 在抗HBc阳性捐赠者中,调查确认性测试的有效性和罕见血型的代表性至关重要.
研究的目的:
- 评估确认性抗HBc测试在识别真实HBV暴露时的有效性.
- 评估抗HBc阳性捐赠者中罕见血型,特别是Ro血型的患病率.
- 了解捐赠者排斥对罕见血型供应的影响.
主要方法:
- 测试了397个HBV表面抗原阴性和最初抗HBc反应性献血者样本,使用五种不同的抗HBc测定.
- 采用建筑师的抗HBc测定,Murex测定和抗HBc中和进行确认.
- 分析抗HBc阳性与抗HBc阴性捐赠者的种族和Ro血型频率.
主要成果:
- 八成的样本最初在建筑师试验中反应,通过Murex试验和中和证实了阳性.
- 在397个样本中,有11个样本显示出不一致的结果,在广泛测试后,有5个样本仍未确定.
- 反HBc阳性献血者不成比例地来自少数民族 (38%) 与反HBc阴性献血者 (11%),非白人反HBc阳性个体中Ro血型的频率高出18倍.
结论:
- 使用两种抗HBc检测有效地识别了暴露在HBV和潜在的传染性捐赠者,以便推迟和随访.
- 确定的抗HBc阳性供体排除影响了罕见血型的可用性,例如Ro.
- 确认性检测平衡了输血安全与维持多样化和充足血液供应的需要.
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