摘要
目的多中心分析继发性免疫功能低下患者HBV、HCV、HIV的感染状况。方法收集国内10家医疗机构2021年7月—2021年12月和2023年1月—2023年6月术前及输血前患者血液样本,分别采用免疫血清学和核酸检测技术进行HBV、HCV、HIV检测。结果本研究共收集患者血液样本25927例,其中继发性免疫功能低下患者4609例(17.78%),包含血液透析患者19例,器官移植患者44例,恶性肿瘤患者4546例;检测同期一般患者21318例(82.22%)。免疫功能低下患者中HBV、HCV、HIV的检出率分别为7.29%、0.28%和0.09%;一般患者中HBV、HCV、HIV的检出率分别为5.40%、0.32%和0.05%,其中HBV阳性检出率差异具有统计学意义。在免疫功能低下患者中,血清学检测阴性、核酸检测阳性的检出率为1.04%(48例);血清学检测阳性、核酸检测阴性的检出率为0.52%(24例)。在一般患者中,血清学检测阴性、核酸检测阳性的检出率为0.82%(174例);血清学检测阳性、核酸检测阴性的检出率为0.42%(89例)。结论免疫功能低下患者HBV检出概率高于一般人群患者;核酸检测技术有助于提高手术前/输血前免疫功能低下患者的HBV检出率。
Objective To investigate the infection status of HBV,HCV,and HIV in patients with secondary immunodeficiencyby a multicenter analysis.Methods Blood samples of preoperative or pre-transfusional patients were collected from ten medical institutions for HBV,HCV and HIV detection from July 2021 to December 2021 and from January 2023 to June 2023.Results A total of 25927 samples were collected in this study,including 4609(17.78%)from patients with secondary immunodeficiency,comprising 19 patients on hemodialysis,44 patients undergone organ transplantation,and 4546 patients with malignant tumors.During the same period,21318 general patients(82.22%)were also tested.Thepositive rates of HBV,HCV and HIV in secondary immunodeficiency patients were 7.29%,0.28%and 0.09%respectively,while thepositive rates of HBV,HCV and HIV were 5.40%,0.32%and 0.05%in general patientsrespectively.Moreover,there was significant difference in the positive detection rate of HBV assessed by the two methods.Among patients with secondary immunodeficiency,the detection rate of serological negativity and nucleic acid positivity was 1.04%(48 cases),whilethe detection rate of serological positivity and nucleic acid negativity was 0.52%(24 cases).Among general patients,the detection rate of serological negativity and nucleic acid positivity was 0.82%(174 cases),andthe detection rate of serological positivity and nucleic acid negativity was 0.42%(89 cases).Conclusion The risk of HBV infection insecondary immunodeficiency patients was higher than that general patients.Nucleic acid test has the advantage on increasing the detection rate of HBV in immunodeficient patients before surgery and blood transfusion.
作者
张琦
桂嵘
刘娟
张俊
周璐洁
刘凤华
吕先萍
胡俊华
周俊
马兴焕
王鹏
杨江存
杜春红
李喜莹
秦莉
宫济武
夏荣
ZHANG Qi;GUI Rong;LIU Juan;ZHANG Jun;ZHOU Lujie;LIU Fenghua;LV Xianping;HU Junhua;ZHOU Jun;MA Xinghuan;WANG Peng;YANG Jiangcun;DU Chunhong;LI Xiying;QIN Li;GONG Jiwu;XIA Rong(Department of Transfusion Medicine,Huashan Hospital,Fudan University,Shanghai 200040;Department of Transfusion Medicine,the First Affiliated Hospital of Harbin Medical University,Harbin 150007;Department of Blood Transfusion,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730;Department of Transfusion Medicine,Peking University First Hospital,Beijing 100034;Department of Transfusion Medicine,Shaanxi Provincial People′s Hospital,Xi′an 710068;Department of Transfusion Medicine,the Third Xiangya Hospital of Central South University,Changsha 410017;Department of Transfusion Medicine,Tianjin Medical University General Hospital,Tianjin 300052;Department of Transfusion Medicine,Cancer Hospital Chinese Academy of Medical Sciences,Beijing 100020;Department of Transfusion Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Transfusion Medicine,West China Hospital,Sichuan University,Chengdu 610041;Research Center for Technologies in Nucleic Acid-Based Diagnostics and Therapeutics,Changsha 410000)
出处
《临床输血与检验》
2025年第4期478-483,共6页
Journal of Clinical Transfusion and Laboratory Medicine
基金
国家自然科学基金面上项目(No.82070197、No.82370232)资助。
关键词
免疫功能低下
核酸检测
传染病筛查
乙型肝炎病毒
丙型肝炎病毒
人类免疫缺陷病毒
Secondary immunodeficiency
Nucleic acid test
Infectious disease screenings
Hepatitis B virus
Hepatitis C virus
Human immunodeficiency virus
