The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana
The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana
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DOI：
10.1182/blood-2002-04-1084
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发表时间：
2003-03-15
期刊：
影响因子：
20.3
通讯作者：
Opare-Sem, O
中科院分区：
文献类型：
--
作者：
Allain, JP;Candotti, D;Opare-Sem, O
在撒哈拉以南非洲，通过输血传播乙肝病毒的风险被认为是相对较低的，对献血者的检测往往没有进行或做得相对较差。为了重新检查这种态度，我们从加纳一家大医院通过一系列乙肝表面抗原(HBs)检测确定了慢性感染乙肝病毒的献血者。以HBVDNA作为金标准评估检测效果，并评估不同检测策略下受血者感染HBV病毒的风险。颗粒凝集法、试纸片法和酶免疫法(EIIA)的HBs Ag筛查分别检出了54%、71%和97%的乙肝病毒感染者。在血液未经筛查和EIA筛查的情况下，乙肝病毒传播给10岁以下的接受者的风险分别在1：11到1：326之间。对于年长的接受者，由于自然暴露于乙肝病毒的频率很高，风险进一步降低了4倍。总计98%的HBs Ag确认阳性样本中含有HBVDNA。在75%的HBs Ag阳性样本中，HBVDNA载量<1×10(4)IU/m L，多数为抗-HBe阳性。大约0.5%的乙肝表面抗原阴性但抗-HBc阳性的样本含有HBVDNA。在献血者中慢性乙肝病毒感染率为15%的人群中，使用敏感的乙肝表面抗原检测对于防止乙肝病毒感染通过输血传播给幼儿至关重要。然而，这不会对这种感染的流行产生太大影响，除非同时推进保护儿童免受感染的其他战略。
The risk of hepatitis B virus (HBV) transmission by transfusion in sub-Saharan Africa is considered to be relatively low, and testing of blood donors is often not done or is done relatively poorly. To re-examine this attitude, we identified HBV chronically infected blood donors from a major hospital in Ghana with a range of hepatitis B surface antigen (HBsAg) assays. Test efficacy was estimated using HBV DNA as a gold standard, and the risk of HBV infection in blood recipients was estimated for different testing strategies. Particle agglutination, dipstick, and enzyme immunoassay (EIIA) HBsAg screening detected 54%, 71%, and 97% of HBV infectious donors, respectively. The risk of HBV transmission to recipients less than 10 years old ranged between 1:11 and 1:326 with blood unscreened and screened by EIA, respectively. For older recipients, the risk decreased a further 4-fold because of the high frequency of natural exposure to HBV. A total of 98% of HBsAg-confirmed positive samples contained HBV DNA. HBV DNA load was less than 1x10(4) IU/mL in 75% of HBsAg-reactive samples, most of them anti-HBe reactive. Approximately 0.5% of HBsAg-negative but anti-HBc-positive samples contained HBV DNA. The use of sensitive HBsAg tests is critical to prevent transfusion transmission of HBV infection to young children in a population with a 15% prevalence of chronic HBV infection in blood donors. However, this will not have much effect on the prevalence of this infection unless other strategies to protect children from infection are also advanced in parallel.