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目的了解上海地区无偿献血人群乙型肝炎病毒隐匿性感染的情况、病毒基因型的分布及S区氨基酸的突变情况。方法对上海市血液中心2011年10月～2012年7月使用血清学联合核酸检测所作的常规血液筛查结果进行分析,综合乙型肝炎血清学标志物二对半检测结果,以判断献血者HBV DNA+标本的感染状态,从中选择部分HBsAg-HBVDNA+的隐匿性HBV感染(OBI)标本作S区巢式PCR、克隆测序,基因分型和突变分析。结果从250 376(人)份无偿献血者标本中筛查出197例HBsAg-HBV DNA+,包括OBI 172例(0.069%);经S区巢式PCR的47例OBI标本中,有17例扩增出S区:14例为C亚型、突变率为35.71%(5/14),3例为B亚型,有1例发生突变,突变主要发生在S抗原的主要亲水区(MHR)。结论上海地区无偿献血者OBI携带率为0.069%,S抗原MHR区的突变可能是OBI发生的贡献因素之一。
Objective To understand the latent infection of hepatitis B virus in unpaid blood donors in Shanghai, the distribution of virus genotype and the mutation of amino acid in S region. Methods The routine blood screening results of serology combined with nucleic acid test from October 2011 to July 2012 in Shanghai Blood Center were analyzed. The results of two-and-a-half tests of hepatitis B serological markers were combined to determine whether the blood donors HBV DNA + specimens were selected from occult HBV infection (OBI) specimens of partial HBsAg-HBVDNA + for S-zone nested PCR, cloning, sequencing, genotyping and mutation analysis. Results A total of 197 cases of HBsAg-HBV DNA + were screened from 250 376 volunteer blood donors, including 172 cases of OBI (0.069%). Of 47 OBI specimens amplified by S-zone nested PCR, 17 cases were amplified Out of the S region: 14 cases were subtype C, the mutation rate was 35.71% (5/14), 3 cases were subtype B, and 1 case had mutation. The mutation mainly occurred in the main hydrophilic region (MHR) of S antigen. Conclusion The OBI carrying rate of unpaid blood donors in Shanghai is 0.069%. Mutations in MHR region of S antigen may be one of the contributing factors of OBI.