Programa de Pós-Graduação em Hematologia e Hemoterapia do Amazonas (PPGH/UEA/HEMOAM), Manaus 69050-001, Amazonas, Brazil.
Programa de Pós-Graduação em Imunologia Básica e Aplicada (PPGIBA/UFAM), Manaus 69080-900, Amazonas, Brazil.
Viruses. 2024 Oct 19;16(10):1632. doi: 10.3390/v16101632.
Hepatitis B is an infectious disease of worldwide importance and of great interest to transfusion medicine. The Amazon region has areas of high endemicity, outlining a worrying scenario for transfusion and epidemiological safety.
To analyze the profiles of serological and molecular markers for HBV of blood donors from HEMOAM.
Blood donors with different patterns of reactivity in serological and molecular screening for HBV were tested for viral load by the qPCR method at the reference center for liver diseases in the state of Amazonas.
A total of 230,591 donors were tested, with 3104 (1.34%) found reactive for HBV and 2790 (89.9%) found reactive for isolated anti-HBc. Viral load was not detected in 100% of donors reactive only to HBsAg, while 100% of donors with positive anti-HBc and positive HBsAg or HBV NAT demonstrated a detectable viral load. We also detected one case of occult hepatitis B (0.03%) only with reactive HBV NAT and five donors (0.2%) with positive anti-HBc and HBV NAT.
With this result, the great importance of the anti-HBc test for the unsuitability of blood donors was verified, as well as the fundamental introduction of the HBV NAT test in screening for hepatitis B in Brazilian blood banks, as this was the only way to detect the viral infection burden in asymptomatic donors who previously would not be treated, which contributed to the maintenance of the endemicity of hepatitis B in the Brazilian Amazon.
乙型肝炎是一种具有全球重要性且备受输血医学关注的传染病。亚马逊地区存在高地方性流行区域，这为输血和流行病学安全勾勒出了一个令人担忧的情景。
分析来自 HEMOAM 的献血者的乙型肝炎病毒血清学和分子标志物的特征。
对乙型肝炎病毒血清学和分子筛查中出现不同反应模式的献血者进行了病毒载量检测，采用 qPCR 法在亚马孙州肝病参考中心进行检测。
共检测了 230591 名献血者，其中 3104 名（1.34%）对乙型肝炎病毒呈反应性，2790 名（89.9%）对单独的抗-HBc 呈反应性。仅对 HBsAg 呈反应性的献血者中 100%未检测到病毒载量，而抗-HBc 和 HBsAg 或 HBV NAT 均呈阳性的献血者 100%检测到可检测的病毒载量。我们还检测到 1 例隐匿性乙型肝炎（0.03%），仅对 HBV NAT 呈反应性，5 名献血者（0.2%）抗-HBc 和 HBV NAT 均呈阳性。
通过这一结果，验证了抗-HBc 检测对献血者不适宜性的重要性，以及 HBV NAT 检测在巴西血库乙型肝炎筛查中的基本引入，因为这是唯一可以检测无症状献血者病毒感染负担的方法，这些献血者之前不会接受治疗，这有助于维持巴西亚马逊地区乙型肝炎的地方性流行。
