El-Zaatari M, Kazma H, Naboulsi-Majzoub M, Haidar M, Ramlawi F, Mahfoud Z, Ramia S
Department of Laboratory Medicine at Hammoud Hospital, Sidon, Lebanon.
J Hosp Infect. 2007 Jul;66(3):278-82. doi: 10.1016/j.jhin.2007.04.010. Epub 2007 May 30.
Transmission of HBV infection through transfusion of HBsAg-negative blood has been documented. It is evident that low levels of HBV-DNA remain detectable in serum and liver tissue of some patients who clear HbsAg, and that the detection rate is highest in individuals who are 'anti-HBc positive alone'. This study was designed to assess the frequency and clinical significance of 'anti-HBc alone' in Lebanese blood donors. A total of 5511 blood donor samples from three major hospitals representing most regions of the country were tested for anti-HBc, amongst other screening tests. Samples positive for 'anti-HBc alone' were then tested for HBV-DNA and any positive for HBV-DNA were then genotyped and investigated for hepatitis B viral load. The study showed that 203 (3.7%) of randomly selected Lebanese blood donors were confirmed as 'anti-HBc alone'. Of these, 11 (5.4%) were HBV-DNA positive as detected by nested PCR. All samples had HBV-DNA levels below 400 copies/ml and all were genotype D. It can be concluded that HBV was present, although the circulating amount of virus was below the detectable limit for the assay used. Therefore, routine screening for anti-HBc may be required in Lebanese blood donation centres as an additional preventive measure for controlling transmission of HBV via blood transfusion.
已有文献记载通过输注乙型肝炎表面抗原（HBsAg）阴性血液传播乙肝病毒（HBV）感染的情况。显然，在一些清除HBsAg的患者的血清和肝组织中仍可检测到低水平的HBV-DNA，且在“仅抗-HBc阳性”个体中的检出率最高。本研究旨在评估黎巴嫩献血者中“仅抗-HBc阳性”的频率及其临床意义。在该国大部分地区的三家主要医院共采集了5511份献血者样本，除其他筛查检测外，还检测了抗-HBc。对“仅抗-HBc阳性”的样本进行HBV-DNA检测，对任何HBV-DNA阳性样本进行基因分型并检测乙肝病毒载量。研究表明，随机选择的黎巴嫩献血者中有203人（3.7%）被确认为“仅抗-HBc阳性”。其中，通过巢式聚合酶链反应（PCR）检测发现11人（5.4%）HBV-DNA阳性。所有样本的HBV-DNA水平均低于400拷贝/毫升，且均为D基因型。可以得出结论，尽管病毒的循环量低于所用检测方法的可检测限，但仍存在HBV。因此，黎巴嫩的献血中心可能需要对抗-HBc进行常规筛查，作为控制HBV通过输血传播的一项额外预防措施。
