Miletić Manuela, Bingulac-Popović Jasna, Stojić Vidović Miljana, Hećimović Ana, Berendika Mirka, Babić Ivana, Đogić Vesna, Samardžija Marko, Barišić Karmela, Jukić Irena, Mihaljević Ivanka
Croatian Institute of Transfusion Medicine (CITM), Petrova 3, 10000 Zagreb, Croatia.
Abbott Diagnostic Croatia, Koranska 2, 10000 Zagreb, Croatia.
Transfus Clin Biol. 2019 Nov;26(4):257-262. doi: 10.1016/j.tracli.2019.05.001. Epub 2019 May 11.
The anti-HBc prevalence over a 14-years period (2004-2017), trends, infectivity, residual risk, and need for testing in blood donors (BD) of the Croatian Institute of Transfusion Medicine were assessed.
Anti-HBc was tested in 19,969 BD serum samples collected in 2004 (N=7561), 2013 (N=7318) and 2017 (N=5090). All serums were initially screened for HBsAg, anti-HCV, HIV Ag/Ab, and anti-TP. 2013 and 2017 samples were also tested by ID-NAT.
Over a 14-years period, the anti-HBc prevalence significantly decreased among Croatian BD (5.24% in 2004, 2.56% in 2013, and 1.32% in 2017). Similarly, the prevalence of anti-HBc-only profiles decreased from 0.62% in 2004, 0.25% in 2013, and 0.21% in 2017. The 4-time decreasing trend was observed in all age groups of BD from 2017 but mostly among repeat donors (5.90% to 1.38%). First-time donors showed no significant difference in anti-HBc prevalence probably due to their younger age (<29 years) and HBV vaccine status. However, similar anti-HBs carriage rates (80.56%, 87.57%, and 82.09%) were reported in anti-HBc positive donors over the study period. HBsAg and HBV DNA were not detected. No OBI infection was found in the study despite an OBI frequency of 1:10,900 donations previously reported in Croatia. A HBV decreasing residual risks of 68, 88, and 12 per million donations were estimated for years 2004, 2013, and 2017, respectively.
Anti-HBc testing is an additional measure of preventing HBV infection by transfusion. Implementation of anti-HBc testing will result in the deferral of 1.3% BD and should be supported by cost-benefit analyses.
评估克罗地亚输血医学研究所14年期间（2004 - 2017年）抗-HBc流行率、趋势、传染性、残余风险以及献血者检测需求。
对2004年（n = 7561）、2013年（n = 7318）和2017年（n = 5090）采集的19969份献血者血清样本进行抗-HBc检测。所有血清最初均筛查HBsAg、抗-HCV、HIV Ag/Ab和抗-TP。2013年和2017年的样本还采用ID-NAT进行检测。
在14年期间，克罗地亚献血者中抗-HBc流行率显著下降（2004年为5.24%，2013年为2.56%，2017年为1.32%）。同样，仅抗-HBc模式的流行率从2004年的0.62%、2013年的0.25%降至2017年的0.21%。2017年所有年龄组的献血者中均观察到4次下降趋势，但主要出现在多次献血者中（从5.90%降至1.38%）。首次献血者抗-HBc流行率无显著差异，可能是由于他们年龄较小（<29岁）且接种过乙肝疫苗。然而，在研究期间，抗-HBc阳性献血者的抗-HBs携带率相似（分别为80.56%、87.57%和82.09%）。未检测到HBsAg和HBV DNA。尽管此前克罗地亚报告的隐匿性乙肝感染频率为每10900次献血中有1例，但本研究未发现隐匿性乙肝感染。估计2004年、2013年和2017年每百万次献血中乙肝病毒残余感染风险分别降至68、88和12例。
抗-HBc检测是预防输血传播乙肝病毒感染的一项额外措施。实施抗-HBc检测将导致1.3%的献血者延期献血，应通过成本效益分析提供支持。
