Sosa-Jurado Francisca, Hilda Rosas-Murrieta Nora, Guzman-Flores Belinda, Perez Zempoaltecalt Cintia, Patricia Sanchez Torres Ana, Ramirez Rosete Leticia, Bernal-Soto Maribel, Marquez-Dominguez Luis, Melendez-Mena Daniel, Angel Mendoza Torres Miguel, Teresa Lopez Delgado Maria, Reyes-Leyva Julio, Vallejo-Ruiz Veronica, Santos-Lopez Gerardo
Laboratory of Virology and Molecular Biology, Eastern Biomedical Research Center, Mexican Social Security Institute, Puebla, Mexico.
Laboratory of Biochemistry and Molecular Biology, Chemistry Center, Institute of Science, Autonomous University of Puebla, Puebla, Mexico.
Hepat Mon. 2016 Jun 1;16(6):e36942. doi: 10.5812/hepatmon.36942. eCollection 2016 Jun.
The hepatitis B virus (HBV) causes chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. Surface antigen (HBsAg) detection is a definitive test that can confirm HBV infection, while the presence of antibodies against the core protein (anti-HBc) suggests either a previous or ongoing infection or occult hepatitis B infection (OBI).
The aim of the present study was to determine the prevalence of anti-HBc and HBsAg in blood donors. Further, the study aimed to estimate the anti-HBc level at which HBV DNA is detected in putative OBI cases, as well as to search for mutations in the "a" determinant associated with the non-detection of HBsAg in serum.
We conducted a cross-sectional study from 2003-2009. The study included 120,552 blood donors from the state of Puebla, Mexico. Different commercial systems based on microparticles (enzymatic (MEIA) or chemiluminescent (CMIA)) were used to determine the HBsAg and anti-HBc levels. For the detection of HBV DNA, a nested polymerase chain reaction (nested PCR) was used and the genotypes were determined using Sanger sequencing.
Of the 120,552 blood donors, 1437 (1.19%, 95% CI: 1.12 - 1.26) were reactive to anti-HBc, while 82 (0.066%, 95% CI: 0.053 - 0.079) were reactive to HBsAg. Some 156 plasma samples collected in 2009 from anti-HBc-positive/HBsAg-negative blood donors were submitted for HBV DNA detection in a search for probable OBI. Viral DNA was detected in 27/156 (17.3%, 95% CI: 11.5 - 23.1). Our results show an association between HBV DNA or HBsAg and anti-HBc S/CO levels ≥ 4.0. All DNA samples were identified as genotype H and some "a" determinant mutations were identified, although none corresponded to mutations previously reported to hinder the detection of HBsAg by commercial immunoassays.
We observed that as the anti-HBc levels increase, there is a higher prevalence of the viral protein HBsAg in blood donors. Samples testing positive for HBV-DNA were seen to exhibit a ten-fold higher presence of anti-HBc S/CO ≥ 4 than those with S/CO ≥ 1 and < 4.0, which highlights the relevance of anti-HBc determination in blood donor samples.
乙型肝炎病毒（HBV）可导致慢性肝炎、肝硬化和肝细胞癌。表面抗原（HBsAg）检测是确诊HBV感染的决定性检测方法，而核心蛋白抗体（抗-HBc）的存在提示既往或正在进行的感染或隐匿性乙型肝炎感染（OBI）。
本研究旨在确定献血者中抗-HBc和HBsAg的流行率。此外，该研究旨在估计在疑似OBI病例中检测到HBV DNA时的抗-HBc水平，并寻找与血清中未检测到HBsAg相关的“a”决定簇突变。
我们在2003年至2009年进行了一项横断面研究。该研究纳入了来自墨西哥普埃布拉州的120552名献血者。使用基于微粒的不同商业系统（酶免疫分析（MEIA）或化学发光免疫分析（CMIA））来测定HBsAg和抗-HBc水平。对于HBV DNA的检测，使用巢式聚合酶链反应（巢式PCR），并使用桑格测序法确定基因型。
在120552名献血者中，1437人（1.19%，95%置信区间：1.12 - 1.26）抗-HBc呈反应性，而82人（0.066%，95%置信区间：0.053 - 0.079）HBsAg呈反应性。2009年从抗-HBc阳性/HBsAg阴性献血者中采集的约156份血浆样本被送去检测HBV DNA，以寻找可能的OBI。在27/156份样本中检测到病毒DNA（17.3%，95%置信区间：11.5 - 23.1）。我们的结果显示HBV DNA或HBsAg与抗-HBc S/CO水平≥4.0之间存在关联。所有DNA样本均被鉴定为H基因型，并且鉴定出了一些“a”决定簇突变，尽管没有一个与先前报道的阻碍商业免疫测定法检测HBsAg的突变相对应。
我们观察到，随着抗-HBc水平的升高，献血者中病毒蛋白HBsAg的流行率也更高。与抗-HBc S/CO≥1且<4.0的样本相比，检测HBV-DNA呈阳性的样本中抗-HBc S/CO≥4的出现频率高出十倍，这突出了在献血者样本中测定抗-HBc的重要性。
