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目的通过对绵阳地区献血前HBsAg快检及献血后血液筛查确证试验结果进行联合分析,更准确的研究献血者中HBV的真实流行情况。方法收集绵阳市中心血站2015年1-8月的献血前HBsAg快检反应阳性样品,并且从征得同意的反应阳性献血者抽取静脉血样进行HBsAg确证中和试验。从血站检验科收集献血后HBs Ag的筛查反应阳性样品进行HBsAg确证中和试验。最后利用献血前和献血后的确证结果估算HBV的流行率。结果2015年1-8月,绵阳59.4%(177/298)的献血前HBsAg快检反应样本成功采集并进行了确证试验,其确证阳性率为95.5%(169/177)。2015年全年献血后59.0%血液筛查反应样本中和试验阳性(249/422)。2015年绵阳市中心血站共有45 424位献血者,其中献血前快检阳性者422人,通过推算献血前和献血后的确证阳性数计算绵阳地区献血者中总的HBV流行率为1.44%。结论献血前HBsAg的快检有效地阻止从HBV感染献血者中采集血液,目前的快检有着较高的特异性。同时,快检漏检的HBV感染献血者也能在献血后的HBsAg筛查中被检测出来。本研究结合献血前HBsAg快检淘汰和献血后HBsAg反应献血者数据估算了绵阳地区献血者中的真实的HBsAg流行率,提供了1个中国献血者的HBV流行率调查新模型。
Objective To analyze the true prevalence of HBV in blood donors through a joint analysis of the results of blood tests for HBsAg pre-donation and blood screening in Mianyang. Methods Pre-donation HBsAg positive samples were collected from January 2015 to August 2015 in Central Blood Center of Mianyang City, and venous blood samples were obtained from HBsAg-positive neutralization tests from consenting positive donors. HBsAg-positive neutralization assays were performed on HBsAg-positive screening samples collected from the blood-board laboratory for blood donation. Lastly, the prevalence of HBV was estimated using the confirmatory results before and after blood donation. Results From January to August 2015, 59.4% (177/298) samples of HBsAg pre-donation blood samples from Mianyang were successfully collected and confirmed. The positive rate was 95.5% (169/177). Fifty-nine percent of blood screening response samples were positive after neutralization in 2015 (249/422). In 2015, there were 45 424 blood donors in Mianyang Blood Center, of which 422 were positive before blood donation. The total prevalence of HBV in blood donors in Mianyang was 1.44% by calculating the positive numbers before blood donation and after blood donation. Conclusion The rapid detection of HBsAg before blood donation effectively prevents the blood from being collected from HBV infected blood donors. Currently, the rapid detection of HBsAg is of high specificity. In the meantime, HBV-infected blood donors that have been undetected by the rapid test can also be detected in the HBsAg screening after blood donation. In this study, the prevalence of HBsAg in blood donors in Mianyang area was estimated based on pre-donation HBsAg knock-out and donated blood donor data of HBsAg-positive donors, and a new model of HBV prevalence survey in one Chinese blood donor was provided.