首页|计划免疫后出生献血者乙肝无症状慢性感染血清学与分子生物学特征分析

计划免疫后出生献血者乙肝无症状慢性感染血清学与分子生物学特征分析

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目的 了解深圳地区计划免疫后出生献血者乙肝病毒无症状慢性感染情况,分析其血清学和分子生物学特征。方法 将1992年之后出生的无偿献血者的HBsAgELISA阳性血液标本进行乙肝两对半检测和核酸大容量提取,对其BCP/PC区及S区进行巢式PCR扩增及qPCR定量检测,并对产物进行基因测序及序列分析。结果 2020年12月—2022年1月共收集46 632份计划免疫后出生无偿献血者标本,其中含男性31 612份,女性15 020份。通过常规筛查得到ELISA阳性标本99份,经化学发光、巢式PCR、实时荧光PCR等方法检测,61份确证HB-sAg阳性,阳性率0。13%(61/46632)。其中男性49份,阳性率0。16%,女性12份,阳性率0。08%(P<0。05)。50/61份标本获得S序列,经系统进化树分析,其中B型46份[92%(46/50),男性38份,女性8份],C型4份[8%(4/50),男性3份,女性 1 份]。S 区突变频率高的分别N40S(8/46,17。39%),G44E(7/46,15。22%),Q129H/R(6/46,13。04%),Y161F/S(7/46,15。22%),V179A(4/46,8。70%),S53L(2/4,50%),C69T(2/4,50%),I126S/T(2/4,50%)。其中免疫逃逸突变有Q129R和T/1126A/N/S/T。结论 乙肝疫苗接种能大大降低献血者的乙肝表面抗原阳性率,提高输血安全性。高频率的免疫逃逸突变也成为血液安全潜在风险,需要进一步探讨研究。
Serological and molecular biological characteristics of hepatitis B vaccinated donors with asymptomatic chronical infection in Shenzhen
Objective To investigate asymptomatic infection of hepatitis B virus(HBV)among hepatitis B vaccinat-ed donors in Shenzhen,and analyze its serological and molecular characteristics.Methods The HBsAg ELISA positive blood samples of blood donors born after 1992 were collected.HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc were further detected by Roche electrochemiluminescence immunoassay(ECL).BCP/PC and S regions were amplified by Nested-PCRs,HBV DNA quantification were adopted by qPCR simultaneously,and the sequences were also analyzed.Results A total of 46 632 blood samples of donors(31 612 males and 15 020 females)from December 2020 to January 2022 collected,and 99 samples with HBsAg ELISA positive were screened out.After tested by ECL,Nested-PCRs,and real-time fluorescence PCR,61 were confirmed HBsAg positive,with the positive rate at 0.13%(61/46 632),including 49 males(0.16%,49/31 612)and 12 females(0.08%,12/15 020).The HBsAg positive rate of males was higher than that of females(P<0.05).50 out of 61 sequences for S region were obtained.By phylogenetic analysis,there were 46 cases of type B(92%,46/50,38 males and 8 females),4 cases of type C(8%,4/50,3 males and 1 female).The high frequency mutations observed in S region were N40S(8/46,17.39%),G44E(7/46,15.22%),Q129H/R(6/46,13.04%),Y161F/S(7/46,15.22%),V179A(4/46,8.70%),S53L(2/4,50%),C69T(2/4,50%)and I126S/T(2/4,50%),including the immune escape mutations Q129R and T/I126A/N/S/T.Conclusion Hepatitis B vaccination can significantly reduce the positive rate of HBsAg and increase the safety of blood transfusion.The high frequency immune escape mutations have become a poten-tial risk of blood safety,and need to be further explored.

hepatitis B virus(HBV)blood donorshepatitis B vaccineimmune escape mutations

叶贤林、李彤、王若楠、李然、刘衡、曾劲峰

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深圳市血液中心,广东深圳 518040

乙型肝炎病毒 献血者 乙肝疫苗 免疫逃逸突变

广东省自然科学基金深圳市重点医学学科基金深圳市三名工程基金

2021A5150109790702024028

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(1)
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