摘要
目的分析献血者中的隐匿性乙型肝炎病毒感染者的血清学特征,探讨HBV S区基因突变在乙型肝炎病毒表面抗原(HBsAg)免疫逃逸中的分子机制。方法采集2021年1月—2022年12月的175583名献血者血液标本进行ELISA/NAT检测,再结合HBV血清学标志物试验确认OBI标本,运用巢式PCR扩增HBV S区并进行测序,使用MEGA 7.0软件进行比对研究。结果共检出82份OBI标本,检出率为0.046%(82/175583)。不同性别献血者标本的OBI检出率无差异(P>0,05),45~54岁年龄段献血者标本的OBI占比(39.02%)最高。血清学标志物检测结果为HBcAb阳性率最高(52.44%)。对12份OBI标本HBV DNA测序分析发现B基因型2份,C基因型10份。对12份标本HBV S区进行巢式PCR发现氨基酸存在T47K、I126S、P127H等基因突变。结论NAT可减少甚至避免OBI引起的输血风险。OBI献血者C基因型中T47K、Q101R高频氨基酸突变可能造成免疫逃逸,致HBsAg检测阴性。
Objective To analyze the serological characteristics of occult hepatitis B virus infection(OBI)in blood donors,and to explore the molecular mechanism of HBV S gene mutation in the immune escape of hepatitis B virus surface antigen(HBsAg).Methods From January 2021 to December 2022,a total of 175583 blood donors were recruited for ELISA/NAT testing.Subsequently,HBV serological marker testing was conducted to confirm the presence of OBI.The HBV S region was amplified using nested PCR and subjected to sequencing analysis.Comparative study was performed using MEGA 7.0 software.Results A total of 82 OBI samples were detected,with a detection rate of 0.046%(82/175583).There was no statistically significant difference in the OBI detection rate among blood donors of different genders(P>0.05).The highest OBI detection rate among blood donors was observed in the age group of 45-54 years,accounting for 39.02%.HBcAb exhibited the highest positive rate at 52.44%.Sequencing analysis of HBV DNA in 12 OBI samples revealed that two cases had genotype B and 10 cases had genotype C.Nested PCR targeting the HBV S region identified amino acid mutations such as T47K,I126S and P127H in all 12 samples.Conclusion The implementation of NAT can effectively mitigate or even eliminate the risk of blood transfusion-associated OBI.The presence of high-frequency amino acid mutations,specifically T47K and Q101R,in the C genotype of OBI blood donors may lead to immune evasion,resulting in a negative HBsAg test.
作者
余薇
王芳
刘强
YU Wei;WANG Fang;LIU Qiang(Jiangxi Blood Center,Nanchang 330052,China)
出处
《中国输血杂志》
CAS
2024年第11期1264-1270,共7页
Chinese Journal of Blood Transfusion
