CAJ | 학술논문

目前乙型肝炎病毒表面抗原(HBsAg)是我国进行献血者进行乙型肝炎病毒(HBV)感染筛查的唯一强制性指标.献血者隐匿性HBV感染(OBI)可能因为筛查而被漏检,影响输血安全.文献报道的献血者中OBI发生率在不同国家或地区不同,为(0.2～111)/10万.HBV高流行国家和地区中,OBI发生率亦相对较高.OBI献血者可将HBV传播给受血者,乙型肝炎核心抗体(anti-HBc)呈阳性的OBI献血者,通过血液制品传播HBV几率较大,而乙型肝炎表面抗体(anti-HBs)呈阳性的OBI献血者,通过血液制品传播HBV几率相对较低.OBI献血者的HBV感染性与输注血液制品中血浆量、病毒载量及受血者免疫状态有关.为降低OBI献血者导致的HBV传播风险,在提高HBsAg检测灵敏度的同时,可使用核酸检测,尽可能降低献血者核酸检测的血液样品数;HBV低流行地区,则合并anti-HBc筛查即可.笔者拟就OBI献血者与受血者接受其输血后HBV感染的相关性研究进行综述,旨在进一步探讨OBI献血者血液成分对受血者的影响,揭示OBI对输血安全的影响.
목전을형간염병독표면항원(HBsAg)시아국진행헌혈자진행을형간염병독(HBV)감염사사적유일강제성지표.헌혈자은닉성HBV감염(OBI)가능인위사사이피루검,영향수혈안전.문헌보도적헌혈자중OBI발생솔재불동국가혹지구불동,위(0.2～111)/10만.HBV고류행국가화지구중,OBI발생솔역상대교고.OBI헌혈자가장HBV전파급수혈자,을형간염핵심항체(anti-HBc)정양성적OBI헌혈자,통과혈액제품전파HBV궤솔교대,이을형간염표면항체(anti-HBs)정양성적OBI헌혈자,통과혈액제품전파HBV궤솔상대교저.OBI헌혈자적HBV감염성여수주혈액제품중혈장량、병독재량급수혈자면역상태유관.위강저OBI헌혈자도치적HBV전파풍험,재제고HBsAg검측령민도적동시,가사용핵산검측,진가능강저헌혈자핵산검측적혈액양품수;HBV저류행지구,칙합병anti-HBc사사즉가.필자의취OBI헌혈자여수혈자접수기수혈후HBV감염적상관성연구진행종술,지재진일보탐토OBI헌혈자혈액성분대수혈자적영향,게시OBI대수혈안전적영향.
At present,hepatitis B virus surface antigen (HBsAg) is the only mandatory index of hepatitis B virus (HBV) infection for blood donor in China.Because of undetected screening sometimes,occult HBV infection (OBI) of blood donors can affect blood safety.The incidence of OBI in blood donors is different in different countries or regions,ranging from 0.000 2 ％ to 0.111％.OBI prevalence is relatively high in HBV high prevalence countries and regions.HBV can be transmitted to blood recipients from blood components of OBI blood donors.HBV transmission rate is high in OBI blood donors with hepatitis B core antibody (anti-HBc) positive,while low in those with hepatitis B surface antibody (anti-HBs) positive.The HBV infectivity of OBI blood donors is related to the amount of blood plasma,viral load and immune status of the recipients.In order to reduce the risk of HBV transmission by OBI blood donors,nucleic acid testing can be used while improving the detection sensitivity of HBsAg.The number of blood donors' blood samples for nucleic acid testing can be reduced,and anti-HBc screening can be used in HBV low endemic area.The authors intend to summarize the correlation between OBI blood donation and HBV infection after blood transfusion,and further explore the effects of blood components from OBI donors on blood recipients.This review aims to reveal impact of OBI on the safety of blood transfusion.