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中国献血员、血浆池及血浆衍生制品中细小病毒 B19 DNA 和抗体。

Parvovirus B19 DNA and antibodies in Chinese plasma donors, plasma pools and plasma derivatives.

机构信息

Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China.

Beijing Wantai Biological Pharmacy, Beijing, China.

出版信息

PeerJ. 2023 Aug 4;11:e15698. doi: 10.7717/peerj.15698. eCollection 2023.

Abstract

BACKGROUND

Human parvovirus B19 (B19V) is a common contaminant found in plasma pools and plasma derivatives. Previous studies were mainly focused on limited aspects, further assessment of prevalence of B19V DNA and antibodies in plasma donors, the contamination of B19V in pooled plasma and plasma derivatives should be performed in China.

STUDY DESIGN AND METHODS

Individual plasma donors' samples from four provinces and pooled plasma from four Chinese blood product manufacturers were collected and screened using B19V DNA diagnostic kits between October 2018 and May 2020. The positive samples were investigated for the seroprevalence of B19V antibodies and subjected to sequence analysis and alignment for phylogenetic studies. Moreover, 11 plasma donors who were B19V DNA-positive at their first testing were also followed during the later donation period. Additionally, 400 plasma pools and 20 batches of plasma derivatives produced by pooled plasma with a viral load of B19V DNA exceeding 10IU/mL were also collected and tested for B19V DNA and antibodies.

OBJECTIVES

To comprehensively and systematically determine the frequency and viral load of B19V DNA in plasma donors, pooled plasma, and plasma derivatives from four Chinese blood product manufacturers.

RESULTS

A total of 17,187 plasma donors were analyzed and 44 (0.26%) specimens were found positive for B19V DNA. The quantitative DNA levels ranged from 1.01 × 10 to 5.09 × 10 IU/mL. Forty-four DNA-positive specimens were also investigated for the seroprevalence of B19V antibodies, 75.0% and 2.3% of which were seropositive for B19V IgG and IgM antibodies, respectively. The phylogenic analyses showed that the prevalent genotypes in the four provinces' plasma donors belonged to B19V Genotype 1. Eleven individual plasma donors who were B19V DNA-positive at the first donation were then followed for a period, and in general, the DNA levels of B19V gradually decreased. Moreover, 64.8% (259/400) of the pooled plasma was contaminated by B19V, with concentrations of 1.05 × 10-3.36 × 10IU/mL. Approximately 72.6% of the DNA-positive plasma pools were only moderately contaminated (<10 IU/mL), while 27.4% contained >10 IU/mL. Twenty batches of plasma derivatives produced by pooled plasma with a viral load of B19V DNA exceeding 10IU/mL were also tested. B19V was detected in 5/5 PCC samples and 5/5 factor VIII samples but was not found in the intravenous immune globulin and albumin samples.

CONCLUSION

The contamination of B19V in pooled plasma and plasma-derived clotting factor concentrates is serious. Whether B19V nucleic acid testing (NAT) screening of plasma and plasma derivatives is launched in China, blood product manufacturers should spontaneously perform B19V NAT screening in plasma donors and mini-pool plasma. These measures can ensure that samples with high titer B19V DNA are discarded in order to prevent and control this transfusion transmitted virus.

摘要

背景

人细小病毒 B19(B19V)是血浆池和血浆衍生物中常见的污染物。先前的研究主要集中在有限的方面,应在中国进一步评估血浆供体中 B19V DNA 和抗体的流行率、B19V 在混合血浆和血浆衍生物中的污染情况。

研究设计和方法

2018 年 10 月至 2020 年 5 月期间,使用 B19V DNA 诊断试剂盒从四个省份的个体血浆供体样本和四个中国血液制品制造商的混合血浆中采集和筛选。对阳性样本进行 B19V 抗体血清阳性率调查,并进行序列分析和系统发育研究。此外,对首次检测时 B19V DNA 阳性的 11 名血浆供体在随后的捐赠期间进行了随访。此外,还收集了 400 个血浆池和 20 批由病毒载量超过 10IU/mL 的混合血浆生产的血浆衍生物,对其进行 B19V DNA 和抗体检测。

目的

全面系统地检测来自四个中国血液制品制造商的血浆供体、混合血浆和血浆衍生物中 B19V DNA 的频率和病毒载量。

结果

对 17187 名血浆供体进行了分析,发现 44 份(0.26%)标本 B19V DNA 阳性。定量 DNA 水平范围为 1.01×10 至 5.09×10 IU/mL。对 44 份 DNA 阳性标本进行了 B19V 抗体血清阳性率调查,75.0%和 2.3%分别为 B19V IgG 和 IgM 抗体血清阳性。系统发育分析显示,四个省份血浆供体中流行的基因型属于 B19V 基因型 1。随后对 11 名首次捐献时 B19V DNA 阳性的个体血浆供体进行了随访,总体而言,B19V 的 DNA 水平逐渐降低。此外,64.8%(259/400)的混合血浆被 B19V 污染,浓度为 1.05×10-3.36×10IU/mL。约 72.6%的 DNA 阳性血浆池仅被中度污染(<10 IU/mL),而 27.4%的血浆池含有>10 IU/mL。对 20 批由病毒载量超过 10IU/mL 的混合血浆生产的血浆衍生物进行了检测。在 5/5 PCC 样本和 5/5 因子 VIII 样本中检测到 B19V,但在静脉注射免疫球蛋白和白蛋白样本中未检测到 B19V。

结论

混合血浆和血浆衍生的凝血因子浓缩物中 B19V 的污染情况严重。无论中国是否开展血浆和血浆衍生物的 B19V 核酸检测(NAT)筛查,血液制品制造商都应自发对血浆供体和小池血浆进行 B19V NAT 筛查,以确保丢弃高滴度 B19V DNA 的样本,从而预防和控制这种输血传播病毒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0187/10405795/52a2c1c645f7/peerj-11-15698-g001.jpg

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