Tejada-Strop Alexandra, Zafrullah Mohammad, Kamili Saleem, Stramer Susan L, Purdy Michael A
Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Scientific Affairs, American Red Cross, Gaithersburg, Maryland.
Transfusion. 2018 Dec;58(12):2761-2765. doi: 10.1111/trf.14916. Epub 2018 Oct 4.
Recently, there has been an increase in the number of hepatitis A outbreaks in the United States. Although the presence of hepatitis A virus (HAV) RNA in blood donors is known to be low, HAV antibody prevalence in this population is unknown.
Samples from 5001 US blood donors collected primarily in the midwestern United States in 2015 were tested for the presence of HAV IgG antibodies using chemiluminescent microparticle immunoassays on the ARCHITECT platform (Abbott Laboratories).
The overall prevalence of IgG anti-HAV was 60%. Only one specimen was IgM anti-HAV positive, for an incidence of 0.02%. IgG anti-HAV prevalence among donors aged 16 to 19 years was 67%, decreased to 54% among donors aged 40 to 49 years and increased to 70% among donors aged 80 to 93 years. No differences were seen by sex with overall IgG anti-HAV prevalence of 61% and 60% for males and females, respectively. Among the five states (Illinois, Indiana, Kansas, Kentucky, and Missouri) with the highest number of donors tested, IgG anti-HAV prevalence in Missouri (65%) was significantly higher (p <0.01) than that in Illinois (52%) or Kentucky (59%). No other significant differences between states were noted.
This study demonstrates the overall high rates of IgG anti-HAV in US blood donors, with the low associated risk of HAV transfusion transmission likely the result of low incidence and effective vaccination.
最近,美国甲型肝炎暴发的数量有所增加。虽然已知献血者血液中甲型肝炎病毒(HAV)RNA的存在率较低,但该人群中HAV抗体的流行率尚不清楚。
使用ARCHITECT平台(雅培实验室)的化学发光微粒免疫分析法,对2015年主要在美国中西部采集的5001名美国献血者的样本进行HAV IgG抗体检测。
IgG抗-HAV的总体流行率为60%。仅1份标本IgM抗-HAV呈阳性,发病率为0.02%。16至19岁献血者中IgG抗-HAV的流行率为67%,40至49岁献血者中降至54%,80至93岁献血者中升至70%。按性别未见差异,男性和女性的总体IgG抗-HAV流行率分别为61%和60%。在检测献血者数量最多的五个州(伊利诺伊州、印第安纳州、堪萨斯州、肯塔基州和密苏里州)中,密苏里州(65%)的IgG抗-HAV流行率显著高于伊利诺伊州(52%)或肯塔基州(59%)(p<0.01)。未发现其他州之间有显著差异。
本研究表明美国献血者中IgG抗-HAV的总体发生率较高,HAV输血传播的相关风险较低可能是发病率低和有效接种疫苗的结果。