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目的研究本地区无偿献血者隐匿性HBV感染(OBI)发展预后以及性传播的可能。方法追踪随访25名来自2010-2012年确认为OBI的无偿献血者及其配偶,采用化学发光方法检测HBs Ag,常规核酸检测方法(NAT)及Nested-PCR方法扩增BCP/PC、S基因确认HBV DNA的存在;实时荧光定量检测方法(QPCR)定量乙肝病毒载量。结果从25名OBI献血者,成功追踪回访15名及6/15名献血者配偶,15名OBI献血者男女比例为8∶7,病毒载量范围在<(10-121.8)IU/m L(中位数14.3 IU/m L),9/15例为抗-HBc阳性。在2-4年后的随访结果,15名OBI献血者有4名(26.7%)转为显性HBV感染(HBs Ag+/HBV DNA+),7名(46.6%)献血者HBV转阴(HBs Ag-/HBV DNA-),4名(26.7%)仍呈OBI持续感染状态(HBs Ag-/HBV DNA+)。OBI转为HBV的献血者的病毒载量显著高于原来OBI感染状态(P<0.05),而仍维持OBI感染献血者的病毒载量与2-4年前相比没有统计学差异(P>0.05)。6名OBI献血者的配偶,均为没有感染HBV(HBs Ag-/HBV DNA-)。结论感染OBI献血者存在自然清除病毒及转为显性HBV感染的发展预后,HBV感染者的起源是否与OBI有关,有待进一步探索。
Objective To study the prognosis of occult HBV infection (OBI) and the possibility of sexual transmission in unpaid blood donors in this area. Methods Totally 25 unpaid blood donors and their spouses identified as OBI from 2010 to 2012 were followed up. The chemiluminescence method was used to detect HBsAg. Conventional nucleic acid detection (NAT) and Nested-PCR were used to amplify BCP / PC and S genes. The presence of HBV DNA; quantitative real-time fluorescence detection (QPCR) to quantify hepatitis B virus load. RESULTS: Twenty-five OBI donors successfully tracked 15 spouses and 6/15 spouse of blood donors. The odds ratio between male and female of 15 OBI donors was 8: 7 and viral load range was <(10-121.8) IU / mL Median 14.3 IU / m L), 9/15 were anti-HBc positive. At follow-up 2-4 years later, 4 (26.7%) of 15 OBI donors were switched to dominant HBV infection (HBs Ag + / HBV DNA +) and 7 (46.6%) donors were HBV negative - / HBV DNA -), 4 (26.7%) still showed persistent OBI status (HBs Ag- / HBV DNA +). The viral load of blood donors who switched from OBI to HBV was significantly higher than that of the original OBI (P <0.05), while the viral load of blood donors who maintained OBI did not show any significant difference (P> 0.05). The spouses of the 6 OBI donors were all not infected with HBV (HBsAg- / HBV DNA-). CONCLUSION: The prognosis of patients with OBI who have spontaneous eradication and transfection to dominant HBV infection is unknown. The origin of HBV infection is related to OBI, and needs to be further explored.