Araujo Patricia, Dodd Roger Y, Latinni Flavia, Souza Renata, Diaz Ricardo, Barreto Jose Augusto
Infection Diseases Laboratory, Colsan/UNIFESP, Avenida Indianópolis, 1260 Indianópolis, São Paulo, SP, Brazil.
American Red Cross, USA.
J Biomark. 2013;2013:812170. doi: 10.1155/2013/812170. Epub 2013 Dec 3.
Background. During routine donor screening in the blood bank, it is not uncommon to find isolated reactivity for anti-HBc in the absence of detectable HBV DNA in a first donation but absence of reactivity to anti-HBc in subsequent donations, suggesting a false-positive result for anti-HBc. Study Design and Methods. The blood donor population was screened between January 2010 and October 2011. We selected 2,126 donations positive only for anti-HBc from a total of 125,068 donations. During the process, OBI donors were identified, and their HBcAg-specific T-cell response was analyzed and compared to donors with chronic (HBsAg positive) and recovered (anti-HBc only) infection. We analyzed correlations between signal levels (Co/s) in the competitive assay for anti-HBc and HBV DNA detection. Results. In the 21-month study period, 21 blood donors with anti-HBc alone were identified as OBI (1 in each 5955 donors). The relevant finding was the observation that anti-HBc only subjects with Co/s ≥ 0.1 did not have either HBcAg-specific T-cells or detectable HBV DNA and OBI subjects presented with Co/s ≤ 0.1 and HBcAg T-cell response. In the subset of 21 OBI subjects, 9 donors remained positive for HBcAg T-cell response after four collections. In all 9 samples, we observed HBV DNA fluctuation. Conclusion. Our data suggest that HBcAg-specific T-cell response could be used to confirm anti-HBc serological status, distinguishing previous exposure to Hepatitis B virus from anti-HBc false-positive results.
背景。在血库进行常规献血者筛查时，首次献血时发现抗-HBc单独反应性且检测不到HBV DNA，但后续献血时抗-HBc反应性消失的情况并不少见，提示抗-HBc结果为假阳性。研究设计与方法。在2010年1月至2011年10月期间对献血人群进行筛查。我们从总共125,068次献血中选出仅抗-HBc阳性的2,126次献血。在此过程中，识别出隐匿性乙肝病毒感染（OBI）献血者，并分析他们的HBcAg特异性T细胞反应，并与慢性（HBsAg阳性）和康复（仅抗-HBc）感染的献血者进行比较。我们分析了抗-HBc竞争检测中的信号水平（Co/s）与HBV DNA检测之间的相关性。结果。在21个月的研究期间，21名仅抗-HBc阳性的献血者被确定为OBI（每5955名献血者中有1名）。相关发现是，Co/s≥0.1的仅抗-HBc受试者既没有HBcAg特异性T细胞也没有可检测到的HBV DNA，而OBI受试者的Co/s≤0.1且有HBcAg T细胞反应。在21名OBI受试者的子集中，9名献血者在四次采血后HBcAg T细胞反应仍为阳性。在所有9个样本中，我们观察到HBV DNA波动。结论。我们的数据表明，HBcAg特异性T细胞反应可用于确认抗-HBc血清学状态，将既往乙肝病毒暴露与抗-HBc假阳性结果区分开来。
