ABSTRACT
【Objective】 To study and analyze the serological and viral charactereristics of hepatitis B virus(HBV) infection in voluntary blood donors in Qingdao. 【Methods】 315 520 blood samples of voluntary blood donors were screened by ELISA combined with nucleic acid testing (NAT). All HBsAg-/HBV DNA+ samples were subjected to high-precision viral load detection and five serological markers of HBV. The sequence of HBV S gene was detected by PCR direct sequencing, and virus genotypes and amino acid mutations were analyzed. 【Results】 A total of 604(0.20%)HBV ELISA or NAT reactive samples were detected: HBsAg+ /HBV DNA- in 307(0.10%) cases, HBsAg-/HBV DNA+ in 138(0.04%) and HBsAg+ /HBV DNA+ in 157(0.05%). Among the 138 HBsAg-/HBV DNA+ donors, 118(85.5%) carried anti-HBc, and 45 (32.61%) carried sole anti-HBc and 5 (3.62%) carried both HBsAg and anti-HBc. In viral load detection, 64 were quantitatively negative and 74 were quantitatively positive, of which 42 were HBV DNA 20 IU/mL. 13 HBsAg-/HBV DNA+ samples were successfully amplified and sequenced, and 5 were genotype B, presenting a total of 17 amino acid mutations without any deletion or insertion, and 8 were genotype C, presenting a total of 41 amino acid mutations and 2 amino acid deletions. 【Conclusion】 NAT, in combination of ELISA, provides additional safety in detecting potentially infectious HBV during the window period and occult HBV infection (OBI). The viral load was low in OBI infected donors, and anti-HBc+ was the main manifestation.The dominating HBV genotypes are genotype B and C, suggesting HBsAg amino acid mutations may be related to the formation of OBI.
ABSTRACT
【Objective】 To compare the detection performance of Cobas s201, a minipool(MP) nucleic acid test(NAT) system, and Panther, a individual donation(ID) NAT system, in blood donor screening. 【Methods】 NAT was conducted on 126 359 blood samples, and initially reactive (IR) samples were either discriminated or resolved by ID testing.The non-discriminated reactive (NDR) samples implicated in Panther sysytem were subjected to ID-NAT by Cobas s201. Some non-repeatable reactivet(NRR) and repeatable reactive (RR) samples implicated in Cobas s201 system were subjected to ID-NAT by Panther. 【Results】 61 MP-IR cases were implicated in a total of 85 128 samples that detected by Cobas 201, and 29(0.34‰) were RR after resolved by ID testing. 74(1.79‰)IR samples were implicated in 41 231 samples that detected by Panther, and 22 (29.73%) were DR-HBV after discriminatory test. Among the NDR 28 samples detected by Panther multiplex system, 7 were positive by Cobas s201 single sample (PP1) whereas non-reactive in simulated MPs of six by Cobas 201.In 28 RR samples resolved by Cobas 201, 24 positive and 4 negative samples were retested by Panther. Among the 11 samples presenting inconsistent retest results by Panther and Cobas 201, 10 were anti-HBc positive, carrying low viral load HBV. 【Conclusion】 The NAT-yield by Panther was significantly higher than that by Cobas s201. Some samples with negative discriminatory results were OBI, and it is necessary to further track and verify the unidentified samples. Cobas s201 is more suitable for a wide array of MP-NAT testing while Panther sample loading, which is flexible and easy to operate, is more suitable for ID-NAT with medium sample size.
ABSTRACT
Objective To analyze the blood screening results after adjustment of critical value 40 to 50 U/L and to observe the effect of reducing blood scrap rate and to discuss the correlation between ALT and HBV,HCV infection.Methods We screened 2656 blood donors (ALT >40 U/L)by serological and nucleic acid amplification testing(NAT)in Qingdao blood center from 2013 to 2014,and conducted the correlation analysis by chi square test.Results 1 771 cases (66.68%)were ALT 40-50 U/L,including 6 cases of HBsAg ELISA (+),2 cases NAT (+),4 cases NAT(-).In the 8 cases of anti-HCV ELISA (+)samples,4 cases NAT (+),3 cases NAT (-),1 case with positive TP without NAT result.In 885 blood donors with ALT>50 U/L,5 cases were HBsAg-reactive,7 cases were anti-HCV-reactive,and 873 cases were negative.Related statistics showed that there was no signifi-cant difference between ALT and HBV infection (P 0.05).Conclusion The proportion of blood donors with ALT 40-50 U/L is much higher than that with ALT >50 U/L do-nors.Adjustment of the critical value greatly reduces blood scrap rate.Elevated ALT is associated with the infection of HBV but not with HCV.
ABSTRACT
Objective To investigate the residual risks of transfusion-transmitted HBV/HCV/HIV in current donor screening system of Qingdao area.Methods After the ELISA tests(HbsAg,anti-HCV,anti-HIV) were performed,NAT tests of HBV-DNA,HCV-RNA,and HIV-RNA on plasma samples were conducted.Such specimens as have discrepant ELISA and NAT results(N+/E-,or N-/E+) were subject to further follow-up confirmation tests.Results Among 12000 donor samples,no sample with anti-HCV(-)/HCV-RNA(+) or with anti-HIV(-)/HIV-RNA(+) was detected.However,2 individuals were detected as HBsAg(-)/HBV-DNA(+).One donor had negative ELISA test results in HBsAb,HBeAg,HBeAb,and HBcAb at the first screening.But the HBsAg,HBeAg and HBcAb were confirmed positive along with HBV-DNA after 11 weeks.The other donor was negative for HBsAb,HBeAg,and HBeAb but positive for HBcAb.Follow up tests after 3 weeks indicated the same serological results,with a similar low viralload at about 1000 IU/mL.Conclusion Due to the window period and occult HBV infection,current blood donor screening system has some residual risks of transfusion-transmitted HBV.NAT and HBcAb tests should be implemented to reduce the residual risks of transfusion-transmitted HBV.