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日本献血者中人细小病毒 B19 抗原化学发光酶免疫分析筛查的影响。

Impact of chemiluminescent enzyme immunoassay screening for human parvovirus B19 antigen in Japanese blood donors.

机构信息

Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan; Japanese Red Cross Plasma Fractionation Center, Chitose, Japan; Japanese Red Cross Blood Service Headquarters, Tokyo, Japan; Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Maryland; Paul-Ehrlich-Institut, Langen, Germany.

出版信息

Transfusion. 2013 Oct;53(10 Pt 2):2556-66. doi: 10.1111/j.1537-2995.2012.03949.x. Epub 2012 Nov 12.

Abstract

BACKGROUND

To reduce the risk of human parvovirus B19 (B19V) transmission through contaminated blood for transfusion and plasma-derived products, the Japanese Red Cross (JRC) Blood Centers introduced B19V antigen screening by chemiluminescent enzyme immunoassay (CLEIA-B19V) in 2008.

STUDY DESIGN AND METHODS

Donor samples that were positive by CLEIA-B19V screening were tested for B19V DNA. The sensitivity of CLEIA-B19V was tested using samples of all three genotypes and B19V DNA-positive donations. B19V DNA-positive donations and pooled plasma were quantitatively assayed for B19V DNA. B19V DNA-positive donations were phylogenetically analyzed by polymerase chain reaction direct sequencing.

RESULTS

The sensitivity of CLEIA-B19V was inferred to be approximately 6.3 log IU/mL with the genotype samples and 6.4 log IU/mL with B19V DNA-positive donor samples. Of 417 CLEIA-B19V-positive samples from 1,035,560 donations in Hokkaido, Japan, 101 were positive for B19V DNA. The 198 strains of B19V DNA-positive donations in Hokkaido over the past 15 years clustered exclusively with Genotype 1. After introduction of CLEIA-B19V, the viral load for B19V DNA in all 772 pooled plasma for fractionation from donors in nationwide Japan did not exceed 4 log IU/mL.

CONCLUSION

CLEIA-B19V can detect all three genotypes of B19V (viral load >6.3 log IU/mL) and limit the viral load (<4 log IU/mL) in pooled plasma, and thus such screening has further reduced the risk of transfusion-transmitted B19V infection. These results show that CLEIA-B19V screening at the JRC Blood Centers can be an alternative approach to comply with recommendations regarding B19V in the United States and Europe.

摘要

背景

为降低因输血和血浆衍生产品污染而传播人类细小病毒 B19(B19V)的风险,日本红十字会(JRC)血液中心于 2008 年引入了 B19V 抗原化学发光酶免疫分析(CLEIA-B19V)检测。

研究设计和方法

通过 CLEIA-B19V 筛查呈阳性的供体样本,进行 B19V DNA 检测。采用三种基因型的样本和 B19V DNA 阳性供体样本对 CLEIA-B19V 的灵敏度进行了检测。定量检测 B19V DNA 阳性供体样本和混合血浆。对 B19V DNA 阳性供体样本进行聚合酶链反应直接测序,进行系统进化分析。

结果

通过基因型样本推断 CLEIA-B19V 的灵敏度约为 6.3 log IU/mL,通过 B19V DNA 阳性供体样本推断灵敏度约为 6.4 log IU/mL。在日本北海道的 1035560 个供体样本中,有 417 个 CLEIA-B19V 阳性样本,其中 101 个样本 B19V DNA 阳性。在过去 15 年中,北海道的 198 株 B19V DNA 阳性供体样本均与基因型 1 完全聚类。CLEIA-B19V 引入后,日本全国供体用于分离的 772 份混合血浆的 B19V DNA 病毒载量均未超过 4 log IU/mL。

结论

CLEIA-B19V 可检测 B19V 的所有三种基因型(病毒载量>6.3 log IU/mL),并限制混合血浆中的病毒载量(<4 log IU/mL),因此,这种筛查进一步降低了输血传播 B19V 感染的风险。这些结果表明,JRC 血液中心的 CLEIA-B19V 筛查可以作为一种替代方法,以符合美国和欧洲关于 B19V 的建议。

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