目的了解西安市无偿献血人群隐匿性乙肝（OBI）感染的流行现状、血清学模式,以及高危感染因素,降低输血传播HBV感染的风险性。方法对2012年6月—2013年12月共计263 501份献血者标本采用酶联免疫法进行血清学检测,检测后合格的血液标本进行核酸检测。对HBV DNA阳性标本测定血清学乙肝5项,统计各项检测的检出率。同时运用Logistic回归分析方法分析隐匿性乙型肝炎感染人群的易感高危因素和流行趋势。结果255 614份乙肝表面抗原阴性标本中检测出HBV DNA阳性标本171份,对这171份阳性标本进行乙肝两对半检测,157例为抗-HBs（＋）或抗-HBc（＋）标本,确认为OBI。因此,西安市献血者隐匿性乙型肝炎感染率为0.06%。根据血清学结果,可以分为6种模式。Logistic回归分析结果显示,年龄和是否重复献血两个因素为隐匿性乙型肝炎感染的相关危险因素。年龄〉40岁及初次献血的人群感染隐匿性乙型肝炎的几率较高。结论无偿献血者存在一定比例隐匿性HBV感染,核酸检测有助于提高检出率。年龄和是否重复献血与隐匿性HBV的感染相关。
Objective To understand the sero-prevalence,HBV serum marker models and related risk factors of occult HBV infected donors in Xi＇an and to reduce the risks in transfusion-transmitted HBV infections.Methods 263 501 volunteer blood donation samples were collected from June 2012 to December 2013.All samples were tested by ELISA first,followed by NAT in the qualified samples.The samples with HBsA g（-） DNA（＋） were further tested for the five serological markers and were analyzed on their serological pattern.Besides,multivariable logistic regression analysis was conducted on the information originated from volunteer blood donors.Results Of all 276 341 donors negative for HBsA g,171 donors were positive for HBV DNA.Among these 171 donors,157 demonstrated either the presence of anti-HBs（＋） or anti-HBc（＋）.The rate of occult HBV infection in blood donors in Xi＇an was then determined to be 0.06%.Multivariable logistic regression analysis showed that occult HBV infection is associated with age and whether the donor is a repeated blood donor.Donors over forty years old and donating blood for the first time had a higher percentage of occult HBV infections.Conclusion Donors negative for HBsA g but positive for other HBV markers cannot rule out HBV infection.Nucleic acid testing is especially useful for enhancing the detection rate of occult HBV infection in blood donor units.Occult HBV infection in blood donors in Xi＇an was associated with age and repeated donor status of blood donors.
Chinese Journal of Blood Transfusion
occult hepatitis B virus
logistic regression analysis
nucleic acid testing