Nantachit Niwes, Thaikruea Lakkana, Thongsawat Satawat, Leetrakool Nipapan, Fongsatikul Ladda, Sompan Prakai, Fong Yiu-Lian, Nichols David, Ziermann Rainer, Ness Paul, Nelson Kenrad E
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Transfusion. 2007 Oct;47(10):1803-8. doi: 10.1111/j.1537-2995.2007.01395.x.
Screening of blood donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) has been implemented recently in the United States. There are limited data, however, on the additional NAT yield of donors in developing countries in Asia where the prevalence of infection is higher. In addition, data on hepatitis B virus (HBV) NAT in high prevalence areas are minimal.
A total of 5083 whole-blood donors at the Chiang Mai University Hospital, Thailand, blood bank were evaluated with a commercially available NAT assay (Procleix Ultrio, Gen-Probe, Inc.) to screen individual donations.
No NAT yield cases were found for HIV-1 or HCV. There were 17 samples with discrepant HBV DNA NAT and hepatitis B surface antigen (HBsAg) tests, however. Seven of these were HBV DNA NAT-positive, HBsAg-negative; of these 7, 1 was NAT-positive at baseline, but negative on follow-up, and considered a false-positive, 1 had an acute infection, and 5 had chronic prevalent HBV infections, for a NAT yield of 6 in 4798 HBsAg negative donors (1:800). In addition there were 10 NAT-negative, HBsAg-positive serum samples. All were anti-hepatitis B core antigen immunoglobulin G-positive; on testing with a more sensitive NAT target capture assay, 5 were positive (1.8-20.6 IU/mL) and 5 were negative.
Multiplex NAT screening of individual-donor serum samples in Northern Thailand detected approximately 1 per 800 HBV NAT-positive, HBsAg-negative donors. The especially high prevalence of HBV infection in Thailand and other Asian countries suggests that HBV NAT screening of donors will be more cost-effective than in other areas.
美国最近已实施对献血者进行人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）核酸检测（NAT）。然而，在亚洲感染率较高的发展中国家，关于献血者额外NAT检出率的数据有限。此外，在高流行地区，乙型肝炎病毒（HBV）NAT的数据极少。
泰国清迈大学医院血库对总共5083名全血献血者进行了评估，采用市售的NAT检测方法（Procleix Ultrio，Gen-Probe公司）对每份献血进行筛查。
未发现HIV-1或HCV的NAT检出病例。然而，有17份样本的HBV DNA NAT与乙型肝炎表面抗原（HBsAg）检测结果不一致。其中7份为HBV DNA NAT阳性、HBsAg阴性；在这7份中，1份在基线时NAT阳性，但随访时阴性，被认为是假阳性，1份为急性感染，5份为慢性HBV感染，在4798名HBsAg阴性献血者中NAT检出率为6/4798（1:800）。此外，有10份NAT阴性、HBsAg阳性的血清样本。所有样本抗乙型肝炎核心抗原免疫球蛋白G均为阳性；用更敏感的NAT靶标捕获检测方法检测时，5份为阳性（1.8 - 20.6 IU/mL），5份为阴性。
泰国北部对个体献血者血清样本进行多重NAT筛查，每800名HBV NAT阳性、HBsAg阴性的献血者中约检测出1例。泰国和其他亚洲国家HBV感染率特别高，这表明对献血者进行HBV NAT筛查比其他地区更具成本效益。
