摘要
目的分析广州番禺地区开展核酸血液筛查以来情况,探讨核酸检测技术(NAT)在血液筛查中的应用价值。方法采用罗氏诊断Cobas S201系统对两遍酶免4项(ELISA)及ALT筛查阴性的献血者标本进行HIV-RNA、HCV-RNA和HBV-DNA 3项联合、6样本混样检测,对混样阳性的样本进行拆分实验,并对拆分阳性的标本进行分项确证实验,对确证实验HBV-DNA阳性的样本进行乙肝两对半血清学标志物的酶免检测。结果共完成40 107例标本的核酸混样检测,拆分阳性的标本60例,阳性率为0.150%(60/40 107)。对这60例样本做分项鉴别实验,结果HBV-DNA阳性47例,阳性率为0.117%(47/40 107),其余13例确认阴性。对47例分项鉴别实验HBV-DNA阳性的样的进行乙肝两对半血清学标志物检测,结果显示:单独HBc Ab阳性15例(31.9%),HBc Ab阳性伴HBs Ab弱阳性15例(31.9%)(其中有2例HBs Ab较强阳性S/CO分别达到14.6、22.3),HBe Ab、HBc Ab阳性8例(17.0%),单独HBs Ab阳性4例(8.5%),两对半全部阴性4例(8.5%),HBs Ab、HBe Ab、HBc Ab 3项阳性的1例(2.1%)。结论血站酶免4项及ALT筛查阴性的血液仍然存在一定的输血传染残余风险,HBs Ag阴性HBV-DNA阳性样本的两对半抗体阳性组合模式有6种,以单独HBc Ab阳性和HBc Ab阳性伴HBs Ab弱阳性占比最大。应用ELISA联合NAT进行血站血液筛查能更有效保障血液安全。
Objective To analyze the application of the nucleic acid tests since its first use in blood screening in Panyu district of Guangzhou,and to explore the application value of nucleic acid detection technology( NAT) in blood screening.Methods Roche Diagnostics Cobas S201 system was employed to test on specimens tested negative twice by ELISA and ALT screening for the presence of HIV-RNA,HCV-RNA and HBV-DNA in multiple ways: joint detection of all three indicators,hybridization assay of six specimens. A test was then used to split mixed positive samples,which were then followed by a confirmatory identification test on separate samples. From the identification test,samples positive for HBV-DNA underwent a detection for hepatitis B serological markers. Results A total of 40 107 samples completed nucleic acid hybridization assay,among which,60 split specimens were positive,at a rate of0. 150%(60 /40 107). These 60 cases then underwent a confirmatory identification test,of which,47 cases were confirmed HBV-DNA positive,at a rate of 0. 117%(47 /40 107),while the remaining 13 cases were confirmed to be negative. These47 cases then were tested for hepatitis B serological markers under ELISA. The results showed that 15 cases were only positive for HBc Ab(31. 9%),15 cases were positive for HBc Ab positive and weakly positive for HBs Ab(31. 9%). There were two cases strongly positive for HBs Ab in which the S / CO value reached 14. 6 and 22. 3. 8 cases were positive for both HBeAb and HBc Ab(17. 0%); 4 cases were only positive for HBs Ab(8. 5%). All four cases were negative for hepatitis B serological markers(8. 5%),while one case was positive for HBs Ab,HBe Ab and HBc Ab(2. 1%). Conclusion Some residual risks of infection still remained in blood tested negative by ELISA and ALT screening. There are six kinds of models comprised of different combinations by negative HBs Ag and positive HBV-DNA samples. The model of separate positive HBc Ab and weakly positive HBs Ab accompanied by positive HBc Ab comprised the largest proporti
出处
《中国输血杂志》
北大核心
2015年第4期430-432,共3页
Chinese Journal of Blood Transfusion
