Schennach Harald, Hessenberger Gerald, Mayersbach Peter, Schönitzer Diether, Fuchs Dietmar
Central Institute for Blood Transfusion, University Clinic Innsbruck, Anichstr. 35, Austria.
Med Microbiol Immunol. 2002 Oct;191(2):115-8. doi: 10.1007/s00430-002-0148-8. Epub 2002 Sep 13.
In Austria serum neopterin measurement was introduced as an additional unspecific screening marker for the detection of routinely unscreened viral infections in blood donations in 1994. This study was performed to test for associations between serum neopterin concentrations in blood donations and cytomegalovirus infections of the donors. All consecutive blood donations from volunteer blood donors collected during 1 year were incorporated into the study. Serum neopterin concentrations were measured by enzyme-linked immunosorbent assay (ELISA), and each donation of donors with CMV seronegativity or unknown CMV status was also screened for CMV antibodies by CMV IgG/IgM antibody ELISA. Data of donors who had two or more donations within this period were retrospectively analyzed for CMV seroconversions. CMV seroconversion was defined as a change in the donor's CMV status from antibody negative to positive. Frozen, stored plasma samples of the matching donors were tested for CMV IgM antibodies to confirm seroconversion. CMV seroconversions were classified by antibody patterns. In total, 56,068 consecutive blood donations were given by 44,427 volunteer donors. Among these, 9,105 had more than one donation during the observation period, and 4,329 (47.5%) out of these repeated donors were initially CMV antibody negative, of whom 36 were recruited as candidates for CMV seroconversion; 20 conversions were confirmed. All early infections ( n=8) were associated with neopterin concentrations of more than 13 nmol/l (98th percentile of all donations = 12.1 nmol/l) and all donations were excluded from transfusion solely on the basis of their elevated neopterin level. In addition, 17% of late and carrier states ( n=12) showed elevated neopterin concentrations. Acute CMV infections among blood donors presented with elevated serum neopterin concentrations even before CMV IgG/IgM antibodies were detectable.
1994年，奥地利引入血清新蝶呤检测，作为献血中常规未筛查病毒感染的一种额外非特异性筛查标志物。本研究旨在检测献血者血清新蝶呤浓度与巨细胞病毒感染之间的关联。将一年内从志愿献血者处采集的所有连续献血纳入研究。采用酶联免疫吸附测定（ELISA）法测定血清新蝶呤浓度，对巨细胞病毒血清学阴性或巨细胞病毒状态未知的献血者的每份血液，也通过巨细胞病毒IgG/IgM抗体ELISA法筛查巨细胞病毒抗体。对在此期间有两次或更多次献血的献血者的数据进行回顾性分析，以检测巨细胞病毒血清学转换情况。巨细胞病毒血清学转换定义为献血者的巨细胞病毒状态从抗体阴性变为阳性。对匹配献血者的冷冻、储存血浆样本检测巨细胞病毒IgM抗体，以确认血清学转换。根据抗体模式对巨细胞病毒血清学转换进行分类。共有44427名志愿献血者进行了56068次连续献血。其中，9105人在观察期内有不止一次献血，这些重复献血者中有4329人（47.5%）最初巨细胞病毒抗体阴性，其中36人被招募为巨细胞病毒血清学转换的候选者；20次转换得到确认。所有早期感染（n = 8）均与新蝶呤浓度超过13 nmol/l相关（所有献血的第98百分位数 = 12.1 nmol/l），所有这些血液仅因其新蝶呤水平升高而被排除用于输血。此外，17%的晚期感染和携带状态（n = 12）显示新蝶呤浓度升高。献血者的急性巨细胞病毒感染在巨细胞病毒IgG/IgM抗体可检测到之前就表现为血清新蝶呤浓度升高。
