Objective: To investigate the pattern of hepatitis B virus (HBV) infection and the prevalence of hepatitis D virus (HDV) infection among voluntary blood donors who tested reactive for HBV in Wuhan, and to provide data support for the prevention and treatment of HBV and HDV infections.
Methods: Electrochemiluminescence (ECL) method was used to detect hepatitis B serological markers in the samples with HBsAg and/or HBV DNA reactivity, and the HBV infection in different groups was statistically analyzed. The HDV IgM and IgG antibodies were screened by ELISA, and the prevalence of HDV infection in the retained samples was analyzed.
Results: In 351 ELISA and/or nucleic acid test (NAT) reactive samples, the serological tests for hepatitis B revealed that 4 cases (1.1%) were positive for HBsAg, HBeAg, and anti-HBc, 182 cases (51.9%) were positive for HBsAg, anti-HBe, and anti-HBc, and 55 cases (15.7%) were negative for HBsAg but positive for anti-HBc. Among them, the HBsAg ELISA dual reagent reactive group (HBsAg R&R group) and the HBsAg ELISA single reagent reactive/HBV DNA reactive group (HBsAg R&NR/HBV DNA R group) had the highest rates of HBsAg(+), anti-HBe(+), and anti-HBc(+), accounting for more than 90% and 65%, respectively, followed by low activity of HBV acute infection or chronic carriers, accounting for about 5% and 20%, respectively. In the HBsAg R&NR/HBV DNA NR group, the combined proportion of individuals with anti-HBs single positive and all hepatitis B serological markers negative accounted for 78%, and those who were HBsAg negative but anti-HBc positive accounted for approximately 20%. In the HBsAg NR&NR/HBV DNA R group, there was nearly 9% of HBsAg(+), anti-HBe(+), and anti-HBc(+), the remaining were all HBsAg negative but anti-HBc positive, with a 100% anti-HBc positivity rate in this group. No HDV IgM or IgG antibodies were detected in the retained samples.
Conclusion: Blood donors with HBV-reactive results in blood screening exhibit multiple patterns of infection indicators. The prevalence rate of HDV infection among blood donors in Wuhan is extremely low. However, the risk of asymptomatic occult hepatitis B infection (OBI) blood donors being co-infected with HDV should not be overlooked in areas with high prevalence of HBV.
题目: 武汉地区HBV反应性献血者感染情况调查.
目的: 调查武汉地区乙型肝炎病毒（HBV）反应性无偿献血者乙肝感染规律与丁型肝炎病毒(HDV)感染流行情况，为HBV及HDV的感染防治提供数据支持。.
方法: 对本实验室留样的HBV血液筛查反应性样本，采用电化学发光法（ECL）进行乙肝五项感染指标的检测，统计分析不同组别的HBV感染情况及差异；采用酶联免疫吸附试验（ELISA）对HDV IgM和IgG抗体进行筛查，统计留样标本的HDV感染流行情况。.
结果: 在351份HBV血液筛查ELISA反应性和（或）核酸检测（NAT）反应性标本中，乙肝五项检测共检出大三阳4例（1.1%）、小三阳182例（51.9%）、HBsAg阴性但抗-HBc阳性55例（15.7%）；其中HBsAg ELISA双试剂反应性组（HBsAg R&R组）与HBsAg ELISA单试剂反应性/HBV DNA反应性组（HBsAg R&NR/HBV DNA R组)小三阳感染率最高，分别占比90%以上与65%以上，其次为低活动度的HBV急性感染或慢性携带者，分别占比约5%与20%；HBsAg R&NR/HBV DNA NR组抗-HBs单阳和五项全阴性者合计占比78%，HBsAg阴性但抗-HBc阳性者约占20%；HBsAg NR&NR/HBV DNA R组有近9%的小三阳感染率，其余均为HBsAg阴性但抗-HBc阳性者，且本组抗-HBc全为阳性。所有留样标本中均未检出HDV IgM和IgG抗体。.
结论: 血液筛查结果为HBV反应性的献血者其感染指标表现为多种模式。武汉地区献血人群HDV感染流行率极低，但对于HBV高流行地区，隐匿性乙肝感染者（OBI）合并感染HDV可能给血液安全带来的风险仍不能忽视。.
Keywords: blood donor; hepatitis B virus; hepatitis D virus; blood screening; prevalence.