Saraswat S, Banerjee K, Chaudhury N, Mahant T, Khandekar P, Gupta R K, Naik S
Department of Transfusion Medicine, SGPGIMS, Lucknow, India.
J Hepatol. 1996 Nov;25(5):639-43. doi: 10.1016/s0168-8278(96)80232-7.
BACKGROUND/AIMS: Post-transfusion hepatitis continues to occur, though with decreasing frequency, even after screening donor blood for HBsAg, anti-HBc, anti-HCV and alanine aminotransferase activity. Data from developing countries on the frequency and type of post-transfusion hepatitis are scarce. We undertook this prospective study to determine the incidence and type of post-transfusion hepatitis at our center after transfusion of blood negative for HBsAg by ELISA.
Forty-one patients undergoing open-heart surgery, who had received 3 or more units of HBsAg-negative blood, were followed up. Serum samples of donor units transfused to recipients who developed post-transfusion hepatitis-B were subjected to HBV DNA amplification by the polymerase chain reaction, using two sets of X-gene specific primers which amplified a 250-bp fragment of the HBV DNA.
We found that six of the 41 patients (14.6%) developed post-transfusion hepatitis; four of them (66.6%) developed icteric post-transfusion hepatitis B, whereas two (33.3%) developed anicteric post-transfusion hepatitis C. These six recipients received a total of 48 units of blood and 30 of these 48 units could be subjected to HBV DNA amplification by polymerase chain reaction. Eleven donor samples were polymerase chain reaction positive and had been transfused to three of the four patients who had developed post-transfusion hepatitis B.
We conclude that post-transfusion hepatitis B continues to be the most common cause of post-transfusion hepatitis in India. Screening of donor units for HBsAg by ELISA does not exclude all blood units infectious for hepatitis B virus. Additional measures to ensure safety of blood supply should be sought.
背景/目的：尽管对献血者血液进行乙肝表面抗原（HBsAg）、抗乙肝核心抗体（anti-HBc）、抗丙肝病毒抗体（anti-HCV）及丙氨酸转氨酶活性筛查后，输血后肝炎的发生率持续下降，但仍有发生。发展中国家关于输血后肝炎的发生率及类型的数据匮乏。我们开展这项前瞻性研究，以确定在我们中心经酶联免疫吸附测定（ELISA）检测HBsAg阴性的血液输血后肝炎的发生率及类型。
对41例接受心脏直视手术且输注3个或更多单位HBsAg阴性血液的患者进行随访。对发生输血后乙型肝炎的受血者所输注的献血者单位血清样本，使用两组X基因特异性引物通过聚合酶链反应进行乙肝病毒（HBV）DNA扩增，该引物可扩增出250bp的HBV DNA片段。
我们发现41例患者中有6例（14.6%）发生输血后肝炎；其中4例（66.6%）发生黄疸型输血后乙型肝炎，而2例（33.3%）发生无黄疸型输血后丙型肝炎。这6名受血者共接受了48单位血液，其中48单位中的30单位可通过聚合酶链反应进行HBV DNA扩增。11份献血者样本聚合酶链反应呈阳性，且已输注给4例发生输血后乙型肝炎患者中的3例。
我们得出结论，输血后乙型肝炎仍是印度输血后肝炎最常见的病因。通过ELISA对献血者单位进行HBsAg筛查并不能排除所有感染乙肝病毒的血液单位。应寻求其他措施以确保血液供应的安全。
