Rare detection of hepatitis B and hepatitis C virus genomes by polymerase chain reaction in seronegative donors with elevated alanine aminotransferase.
Rare detection of hepatitis B and hepatitis C virus genomes by polymerase chain reaction in seronegative donors with elevated alanine aminotransferase.
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在丙氨酸氨基转移酶升高的血清阴性供体中，通过聚合酶链反应很少检测到乙型肝炎和丙型肝炎病毒基因组。
DOI：
10.1046/j.1537-2995.1994.34894353458.x
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发表时间：
1994
期刊：
影响因子：
2.9
通讯作者：
Vyas,GN
中科院分区：
文献类型：
--
作者：
Sankary,TM;Yang,G;Romeo,JM;Ulrich,PP;Busch,MP;Rawal,BD;Vyas,GN
背景：自 1990 年引入丙型肝炎病毒 (HCV) 抗体筛查以来，输血后肝炎已降至接近背景水平。这导致人们重新考虑检测捐献血液中丙氨酸转氨酶 (ALT) 升高的价值。通过对 ALT 升高的血液单位血浆中的乙型肝炎病毒 (HBV) 或 HCV 进行聚合酶链反应 (PCR) 检测，评估 ALT 检测在检测血清阴性感染中的作用。 研究设计和方法：采用高度灵敏的半巢式 PCR 程序，对来自相当于 47,500 份献血的 375 单位血浆进行了检测。使用针对 HBV DNA 保守区域和 HCV RNA 5'非编码区域的三联引物，半巢式 PCR 检测可以可靠地将 10 种病毒分子扩增至溴化乙锭染色琼脂糖凝胶中可检测到的水平。使用半巢式 PCR 对来自四位捐献者的血浆池进行了筛选。对于任何反应性池，来自个体供者的血浆以不同的等分试样重新检测两次。结果：375 个单位中的两个单位（均具有中度 ALT 升高）在半巢式 PCR 中反复出现反应（HBV DNA 和 HCV RNA 各一个）。然而，9 个月和 5 个月后测试的两名可疑捐赠者的样本显示，半巢式 PCR 中没有血清转化、ALT 升高或病毒基因组。结论：这项估计有 47,500 名自愿献血者的研究中缺乏确诊的 HBV 或 HCV 感染，这表明在排除 HBV 和/或 HCV 血清阳性血液后，用于进一步预防输血后肝炎的常规 ALT 检测可能是多余的。
Background:Since screening for antibody to hepatitis C virus (HCV) was introduced in 1990, posttransfusion hepatitis has been reduced to nearly background levels. This has led to reconsideration of the value of testing donated blood for elevated alanine aminotransferase (ALT). The contribution of ALT testing in detecting seronegative infection was evaluated by the performance of polymerase chain reaction (PCR) for hepatitis B virus (HBV) or HCV in plasma from ALT‐elevated blood units.STUDY DESIGN AND METHODS:Testing was performed on 375 units of plasma, derived from an equivalent of 47,500 blood donations, with a highly sensitive hemi‐nested PCR procedure. Using a triplet of primers directed at the conserved regions of HBV DNA and 5′‐noncoding regions of HCV RNA, the hemi‐nested PCR assay can reliably amplify 10 viral molecules to levels detectable in ethidium bromide‐stained agarose gels. Pools of plasma from groups of four donors were screened with hemi‐nested PCR. For any reactive pools, the plasma from individual donors was retested twice on different aliquots.RESULTS:Two of 375 units, both with midrange ALT elevation, were repeatedly reactive in hemi‐nested PCR (one each for HBV DNA and HCV RNA). However, samples from the two suspect donors tested 9 and 5 months later revealed no seroconversion, elevated ALT, or viral genomes in hemi‐nested PCR. CONCLUSION: The lack of confirmed HBV or HCV infection in this study representing an estimated 47,500 voluntary blood donations suggests that routine ALT testing for further prevention of posttransfusion hepatitis after exclusion of HBV‐ and/or HCV‐seropositive blood may be superfluous.