血液病毒核酸检测单独阳性标本研究

摘要

Objective To study nucleic acid testing (NAT) yield cases and to evaluate the different NAT methods. Methods Enzyme-linked immunosorbent assay(ELISA) and NAT by transcription mediated amplification(TMA) were applied to test the blood of donation samples simultaneously. The NAT yield cases were rechecked with discriminated test (TMA) ,Hepatitis B serological markers detection and NAT by polymerase chain reaction (PCR). Results Among 47004 specimens,108 NAT yield cases were screened out with negative ELISA test. Forty out of 108 cases were discriminated as HBV without HIV or HCV infection ,which ac-count for the NAT yield rate of 0.85‰. Nine out of 13 cases of HBV owned the same results with TMA and NAT. Two out of 30 cases without HBV infection were confirmed positive HBV infection by means of NAT(PCR) method. Moreover ,43 cases of positive HBV infection accepted the tests of various Hepatitis B serological markers ,which revealed the highest positive rate of HBcAb and uncertainty results of HBsAg on the contrary. Conclusion Most of NAT yield specimens had the chance to be occult HBV infec-tion (OBI),which might cause some differences in different NAT tests.%目的：对酶联免疫吸附检测（ELISA）阴性而核酸检测（NAT）阳性的NAT单独阳性献血标本进行研究分析，评价不同NAT方法检测结果的差异。方法对献血标本进行ELISA的同时，采用转录介导扩增技术（TMA）进行NAT。对NAT单独阳性标本分别进行NAT(TMA)鉴别检测，乙肝血清学标志物检测，HBsAg确证实验和基于聚合酶链式反应(PCR)的NAT。结果在47004例献血标本中，NAT（TMA）联检（HBV、HIV、HCV）出ELISA阴性的NAT阳性标本108例，其中40例鉴别检测为HBV，68例为鉴别阴性，未发现HIV和HCV，HBV的NAT的单阳性率为0.85‰。选取13例NAT(TMA)鉴别为HBV的标本中有9例NAT（PCR）也为HBV；选取30例NAT(TMA)鉴别阴性标本中有2例NAT（PCR）为HBV。选取鉴别阳性13例，阴性30例共计43例NAT（TMA）联检单阳性标本进行乙肝血清学标志物检测，其乙肝血清学标志物中HBcAb阳性率最高， HBsAg确证检测结果均为不确定。结论由于NAT单独阳性标本中大多为隐匿性HBV感染（OBI），可能给不同NAT方法的检测结果带来一定的差异。