混合检测对献血者乙型肝炎病毒表面抗原筛查准确性的影响

Impact of pooling on accuracy of hepatitis B virus surface antigen screening of blood donations.

作者信息

Novack L, Sarov B, Goldman-Levi R, Yahalom V, Safi J, Soliman H, Orgel M, Yaari A, Galai N, Pliskin J S, Shinar E

机构信息

Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 84105, Israel.

出版信息

Trans R Soc Trop Med Hyg. 2008 Aug;102(8):787-92. doi: 10.1016/j.trstmh.2008.04.005. Epub 2008 May 16.

DOI:10.1016/j.trstmh.2008.04.005

PMID:18486172

Abstract

Expenditure on screening blood donations in developing countries can be reduced by testing donations in pools. This study evaluated serological screening in pools for hepatitis B virus (HBV) at the Israeli national blood bank and a hospital blood bank in Gaza, the Palestinian Authority. The accuracy of HBV surface antigen (HBsAg) enzyme immunoassay performed on pools of 3-24 samples was compared with individual tests. Delay in detecting positive samples due to dilution in pools and the possibility of antibody-antigen neutralization were analyzed. The sensitivity of pooled testing for HBsAg was 93-99%, prolonging the window period by 5 days (8.3%). Neutralization of HBsAg by hepatitis B surface antibodies (anti-HBs) could be minimized by testing immediately after pooling. Serological testing for HBsAg in pools may be performed using manually created pools of up to six samples, with 5% loss in sensitivity and a risk of neutralization by anti-HBs present in the donor population. Pooling can therefore be considered as an option only in countries with a low prevalence of HBV.

摘要

通过对献血样本进行混合检测，可以降低发展中国家在献血筛查方面的支出。本研究评估了以色列国家血库和巴勒斯坦权力机构加沙一家医院血库对乙型肝炎病毒（HBV）进行混合血清学筛查的情况。将对3至24份样本混合后进行的HBV表面抗原（HBsAg）酶免疫测定的准确性与单独检测进行了比较。分析了由于样本在混合中被稀释而导致检测阳性样本出现延迟的情况以及抗体 - 抗原中和的可能性。混合检测HBsAg的灵敏度为93% - 99%，窗口期延长了5天（8.3%）。通过在混合后立即检测，可将乙型肝炎表面抗体（抗 - HBs）对HBsAg的中和作用降至最低。HBsAg的混合血清学检测可使用人工混合最多六个样本进行，灵敏度会降低5%，且存在被献血人群中存在的抗 - HBs中和的风险。因此，仅在HBV流行率较低的国家，混合检测才可被视为一种选择。