血液捐献者查中的"灰色区域":一项回顾性研究和对捐献者重新入境的建议
Wajnat A Tounsi1, Nora Y Hakami1, Seraj O Alamoudi2
1Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
Diagnostics (Basel, Switzerland)
|September 13, 2025
概括
血液供献者查的灰色区域结果并不常见,特别是在输血传染性感染 (TTIs) 方面. 提出的六个月的延期和后续测试可以确保血液安全和供体池的可持续性.
科学领域:
- 输血医学 输血医学
- 传染病查 传染病查
- 公共卫生 公共卫生
背景情况:
- 灰色区域血清学结果在血液供献者查中对输血安全和血液供应可持续性提出了挑战.
- 沙特阿拉伯缺乏管理这些灰色区域结果的标准化国家协议.
- 这项研究解决了关于灰色区域结果在献血者的流行率和随访数据的需求.
研究的目的:
- 评估血液捐献者中输血传染性感染 (TTIs) 的灰色区域血清学结果的患病率和随访结果.
- 评估灰色区结果对沙特阿拉伯的捐赠者管理和血液供应可持续性的影响.
- 为制定用于管理灰色区域血清学结果的标准化国家协议提供信息.
主要方法:
- 对6种TTI标志物和HBV,HCV和HIV核酸检测 (NAT) 的血清查结果进行5年分析.
- 灰色区域的定义是0.90-0.99.9之间的信号与切断 (S/CO) 比率.
- 评估重复和后续捐献,以确定血清转化和追踪捐赠者的结果.
主要成果:
- 灰色区域的结果很少见,对抗乙型肝炎核心 (抗HBc) 抗体 (0.16%),C型肝炎病毒 (HCV) (0.08%) 和乙型肝炎表面抗原 (HBsAg) (0.06%) 观察到的频率最高.
- 在随后的捐赠时,灰色区域转化为反应性是罕见的;只有三个初始抗HBc灰色区域结果的捐赠者后来进行了反应性测试,但他们的HBV NAT仍然为负.
- 大多数除HBV以外的TTI标记物的灰色区域结果可能代表了测试变异性,而不是真正的感染.
结论:
- 虽然灰色区域的结果很少出现,但与乙型肝炎病毒 (HBV) 标记物相关的子集在重复测试时显示出低水平的反应性.
- 建议的管理策略包括六个月的临时延期,随后进行血清和NAT测试.
- 具有一致的非反应性结果的供体的有条件重新进入可以支持输血安全和可持续的供体池.
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