Spanish Red Cross Blood Transfusion Center, Madrid, Spain.
Transfusion. 2010 Jan;50(1):221-30. doi: 10.1111/j.1537-2995.2009.02343.x. Epub 2009 Aug 4.
Screening of blood units for hepatitis B virus (HBV) DNA identifies donations collected during the window period (WP) of the acute infection and may improve viral safety of the blood supply. It also leads to the detection of occult hepatitis B infection (OBI).
From January 2005 to December 2006, a total of 383,267 blood units were screened for hepatitis B surface antigen (HBsAg) and HBV DNA in two transfusion centers in Madrid, using either individual-donation nucleic acid testing (ID-NAT) or minipool (MP-NAT) of eight donations (MP8). Samples positive for HBV DNA and negative for HBsAg were confirmed by a second molecular test, the viral DNA was quantified, and a genome fragment including the region encoding the major hydrophilic region (MHR) of HBsAg was sequenced.
The overall yield of HBV DNA-positive, HBsAg-negative units was 1 in 21,282 (18 cases), higher when using ID-NAT than MP8-NAT (1:9862 vs. 1:51,011; p < 0.01). Four donations (1/95,817) were collected during the infectious pre-HBsAg WP, one during an early recovery stage, and the remaining 13 (1/29,482) were OBIs, six of whom had no detectable antibody to HBsAg. Low-level Genotype D HBV DNA was detected in all OBI cases; the frequencies of this genotype and MHR amino acid substitutions were significantly higher than reported from unselected Spanish HBsAg carriers. Donors with OBI had normal aminotransferase levels and were significantly older than donors carrying HBsAg.
Blood donors in the WP and with OBI are not uncommon in Madrid and are detected at a higher frequency with ID-NAT than MP-NAT.
乙型肝炎病毒（HBV）DNA 血筛可发现窗口期（WP）内采集的血液，提高血液供应的病毒安全性，还可能发现隐匿性乙型肝炎感染（OBI）。
2005 年 1 月至 2006 年 12 月，在马德里的两个输血中心，使用个体供者核酸检测（ID-NAT）或 8 份样本混合核酸检测（MP8-NAT）对 383267 份血样进行乙型肝炎表面抗原（HBsAg）和 HBV DNA 筛查。对 HBV DNA 阳性、HBsAg 阴性的样本进行二次分子检测，定量病毒 DNA，并对 HBsAg 主要亲水区（MHR）编码区的基因组片段进行测序。
HBV DNA 阳性、HBsAg 阴性的血样检出率为 1/21282（18 例），ID-NAT 法高于 MP8-NAT 法（1/95817 比 1/51011，P<0.01）。4 例（1/95817）为感染前 HBsAg WP 期、1 例为早期恢复期采集，其余 13 例（1/29482）为 OBI，其中 6 例无 HBsAg 抗体。所有 OBI 病例均检出低水平基因型 D HBV DNA，该基因型和 MHR 氨基酸替换的频率显著高于西班牙未选择的 HBsAg 携带者。OBI 供者的氨基转移酶水平正常，年龄显著大于 HBsAg 携带者。
马德里的 WP 期和 OBI 期血源并非罕见，ID-NAT 法比 MP8-NAT 法检测率更高。
