ABSTRACT
【Objective】 To detect and analyze the infection status of HBsAg non-reactive /HBV DNA reactive blood donors by individual donor-NAT (ID-NAT) and chemiluminescence technology, and to explore the feasibility and potential risks of reentry. 【Methods】 The blood screening results of blood donors in Wuhu from January 2018 to October 2021 were queried by blood station information management software. The blood donation information of all HBsAg non-reactive /HBV DNA reactive blood donors was collected and then recalled by telephone. After informed consent, samples were taken for HBV DNA nucleic acid single test, enzyme-linked immunoassay for HBsAg, chemiluminescence assay for HBV seromarkers(including HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc), and alanine aminotransferase (ALT) test. All the results were statistically analyzed. 【Results】 From January 2018 to October 2021, there were 142 051 donations, and the positive rate of sole HBV DNA was 0.06% (91/142 051), and 33 people (37 person-times) were successfully followed up. The yield rates of HBsAg, anti-HBs and anti-HBc were 6.06% (2/33), 39.39% (13/33) and 96.97% (32/33), respectively; None HBeAg was yielded. After two times of ID-NAT, 8 patients remained non-reactive to both systems, with a negative conversion rate of 24.24% (8/33). Meanwhile, 25 patients were at least once reactive to ID-NAT, and 23 of them were occult HBV infection with serologically reactivity. There were 2(6.25%) patients with HBsAg positive conversion and HBV DNA persistent reactivity, which were window period infection. One person was confirmed as false reactivity (no HBV infection) as he remained unreactive to both repeated ID-NAT and serological tests. 【Conclusion】 Chemiluminescence assay is more sensitive than ELISA in detecting HBV serum markers, which is beneficial to early detection of HBV samples in window period. The yielding rate of anti-HBc among HBsAg non-reactive/HBV DNA reactive blood donors detected by blood screening in this region is very high, and most of them are occulting infection, so the ID-NAT should be no less than 2 times in the reentry strategy.
ABSTRACT
【Objective】 To study the adverse reactions(ADRs) in blood donors after whole-blood donation in terms of frequency and types, so as to explore the predisposing factors of adverse reactions. 【Methods】 A questionnaire was designed to investigate ADRs within 2 weeks after whole blood donation. A total of 812 whole blood donors were randomly selected from September to October 2021. They were interviewed by trained medical staff before leaving the site after blood donation, then followed up by telephone 24 hours and 2 weeks after blood donation. The frequency and type of ADRs were surveyed, and the physical examination data such as gender, age, blood pressure, mean arterial pressure (MAP) and weight were collected to, analyze the predisposing factors that correlated with ADRs. 【Results】 Finally, 734 people [90.39% (734/812)], with valid demographic and physical examination information, were included in this study after on-site interviews and two follow-ups within two weeks after blood donation. The incidence of ADRs was 13.22% (97/734), of which the incidence of on-site vasovagal reactions during blood donation was 10.49% (77/734) (with the constituent ratio as 79.38%, 77/97)and the incidence of ADRs ≤ 2 weeks after leaving the blood collection site was 2.73% (20/734, including 12 donors had (1.63%, 12/734) local symptoms)(with the constituent ratio as 20.62%, 20/97). Multivariate logistic regression analysis showed that the factors influencing the occurrence of ADRs were as follows: 400mL-blood donation (OR 6.312, 95% CI 3.336-11.944), 45~60kg weight (OR 3.744, 95% CI 2.017-6.949), MAP ≤ 90 mmHg (OR 3.101, 95% CI 1.416-6.788), novel blood donor (OR 2.237, 95% CI 1.199-4.174), age of 18~30 years (OR 2.197, 95% CI1.107-4.361), female (OR 1.871, 95% CI 1.026-3.413); blood pressure, occupation, education background, body mass index (BMI) and Hb of blood donors were not the influencing factors and risk predictors of ADRs. 【Conclusion】 The application of on-site interview and two follow-ups after donation can effectively obtain the true information of blood donors′ ADRs, which can timely grasp and predict the relevant factors affecting the occurrence of ADRs, so as to take targeted preventive measures to ensure the safety of blood donors.