Predictive Value of Screening Tests for Persistent Hepatitis C Virus Infection Evidenced by Viraemia
Predictive Value of Screening Tests for Persistent Hepatitis C Virus Infection Evidenced by Viraemia
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以病毒血症为证据的持续性丙型肝炎病毒感染筛查试验的预测价值
DOI：
10.1159/000462423
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发表时间：
1993
期刊：
影响因子：
2.7
通讯作者：
K. Nishioka
中科院分区：
文献类型：
--
作者：
J. Watambe;C. Matsumoto;Kuniko Fujimura;T. Shimada;H. Yoshizawa;H. Okamoto;H. Iizuka;T. Tango;H. Ikeda;N. Endo;T. Mazda;T. Nojiri;K. Aoyama;K. Kanemitsu;Hiroyuki Yamano;M. Mizui;F. Yokoishi;K. Tokunaga;K. Nishioka
1989年11月，日本红十字会血液中心开始用酶联免疫吸附测定法（Elisa）检测C型肝炎病毒（HCV）的C100-3病毒肽，这是世界上第一个这样的全国性方案。此后，输血后非甲非B型肝炎（PTNANBH）减少了61- 80%，但这并不像我们在同一时期开始的通过筛查高滴度B型肝炎核心抗体预防输血后B型肝炎的计划那样完全成功。为了更有效地控制PTNANBH，已采用HCV核心相关抗原（戈尔，N14）和第二代Elisa（Ortho 2，Abbott 2）以及第二代抗原凝集（PA，PHA）试验。在11个血液中心的16，500名献血者中，365人至少有一项血清学检测呈阳性。其中，138个单位检测到HCV RNA，其余227个单位为HCV RNA阴性。分析了这些血清学试验检测HCV RNA阳性状态的有效性。被动血凝和颗粒凝集试验（PHA和PA）是非常有效的预测献血员中的HCV病毒血症。此外，这些测试可以很容易地确定抗体滴度。无论用PHA或PA，所有凝集滴度≥ 212的单位（120和122单位）均为HCV RNA阳性，所有血清丙氨酸氨基转移酶水平高于35 Karmen单位的凝集阳性单位均为HCV RNA阳性。这些结果为在献血者中实施更有效的HCV病毒血症筛查奠定了基础，其有效性被定义为加强对患者的保护，使其免受输血后丙型肝炎的影响，并提供更高质量的信息，以实现更有效的献血者咨询。
In November 1989, Japanese Red Cross Blood Centres started screening for heaptitis C virus (HCV) with enzyme-linked immunosorbent assay (Elisa) for the C100-3 viral peptide as the first such nationwide programme in the world. Thereafter post-transfusion non-A non-B hepatitis (PTNANBH) was reduced by 61-80%, but this was not as complete a success as our programme to prevent post-transfusion hepatitis B by screening for high titer hepatitis B core antibody, which we began in the same period. In order to acquire more effective control of PTNANBH, the HCV core-related antigen (GOR, N14) and second-generation Elisa (Ortho2, Abbott2)and second-generation antigen agglutination (PA, PHA) tests have been employed. Among 16,500 donors in 11 blood centers, 365 were serologically positive by at least one of these tests. Among these, HCV RNA was detected in 138 units and the remaining 227 were HCV RNA negatives. The effectiveness of these serological tests to detect HCV RNA-positive status were analyzed. Passive haemagglutination and particle agglutination (PHA and PA) tests were highly effective to predict HCV viraemia among blood donors. Also, these tests can easily determine antibody titre. By either PHA or PA, all units with ^ 212 agglutination titre (120 and 122 units) were HCV RNA positive and all agglutination-positive units with serum alanine aminotransferase level higher than 35 Karmen units were HCV RNA positive. These results have formed the basis for implementing a more effective screening for HCV viraemia in blood donors, where effectiveness is defined as enhancing the protection of patients from post-transfusion hepatitis C and providing higher quality information to achieve more effective donor counselling.