Lengths of hepatitis B viremia and antigenemia in blood donors: preliminary evidence of occult (hepatitis B surface antigen-negative) infection in the acute stage
Lengths of hepatitis B viremia and antigenemia in blood donors: preliminary evidence of occult (hepatitis B surface antigen-negative) infection in the acute stage
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DOI：
10.1111/j.1537-2995.2007.01234.x
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发表时间：
2007-07-01
期刊：
影响因子：
2.9
通讯作者：
Mizoguchi, Hideaki
中科院分区：
文献类型：
--
作者：
Yoshikawa, Akira;Gotanda, Yuko;Mizoguchi, Hideaki
背景：日本红十字会（JRC）实施了全自动池和核酸扩增试验（NAT）系统来检测血清阴性献血者。JRC样本库和重复献血允许对乙型肝炎病毒（HBV） dna阳性献血者进行回顾和随访研究，这些献血者在JRC筛选系统中乙型肝炎表面抗原（HBsAg）和抗乙型肝炎核心抗原检测为阴性。研究设计和方法：从2000年2月1日至2003年3月31日，在50个样品池中使用半自动多重分析系统（AMPLINAT MPX测试，罗氏）检测了17,314,486个单位。在此期间，发现328例HBV dna阳性供体。从这些供体中的26个中，可以在短时间间隔内获得连续的样本。这使我们能够检查急性HBV感染中病毒标志物的动态。用定量聚合酶链反应法（JRC）、HBsAg酶免疫分析法（Auszyme II、AxSYM、Abbott）和化学发光免疫分析法（Abbott）的结果进行回归分析，估计血浆病毒血症和抗原血症的检测周期长度。结果：在个人捐献和20样本迷你池（MP） NAT格式中，HBV DNA可检测的中位长度估计分别为74天和50天，而HBsAg可检测的中位长度估计为42天。26例献血者中有6例感染了突变病毒，其中3例在整个观察期内未出现可检测到的HBsAg，尽管病毒载量为每ml 10(4) ~ 10(5)个HBV DNA拷贝。结论：突变病毒的传播可能在急性期引起隐匿性HBV感染。HBV NAT，即使在MP配置下，也比HBsAg检测更有效，并且能够在HBsAg前和后窗口期阻断受感染的供体。
BACKGROUND: The Japanese Red Cross (JRC) implemented a fully automated pooling and nucleic acid amplification test (NAT) system for testing seronegative donations. The JRC sample repository and repeat blood donations allowed for lookback and follow-up studies of hepatitis B virus (HBV) DNA-positive donors, who tested negative for hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antigen in the JRC screening system.STUDY DESIGN AND METHODS: From February 1, 2000, to March 31, 2003, 17,314,486 units were tested in 50-sample pools with a semiautomated multiplex assay system (AMPLINAT MPX test, Roche). During this period, 328 HBV DNA-positive donations were found. From 26 of these donors, sequential samples were available at short intervals. This enabled us to examine the dynamics of viral markers in acute HBV infection. The length of detectable periods of plasma viremia and antigenemia were estimated by regression analysis from the results obtained in the quantitative polymerase chain reaction assay (JRC) and HBsAg enzyme immunoassay (Auszyme II, AxSYM, Abbott) and chemiluminescence immunoassay (Abbott).RESULTS: The median length of detectable HBV DNA in individual donation and 20-sample minipool (MP) NAT format was estimated to be 74 and 50 days, respectively, whereas the median length of detectable HBsAg was estimated to be 42 days. Six of the 26 donors were infected with mutant viruses, and 3 of these 6 donors did not develop detectable HBsAg during the entire observation period, despite a moderately high viral load of 10(4) to 10(5) HBV DNA copies per mL.CONCLUSION: Transmission of mutant virus may cause occult HBV infection in the acute stage. HBV NAT, even in MP configuration, is more effective than HBsAg testing and capable of interdicting infected donors in the pre- and post-HBsAg window periods.