Abstract
To evaluate the detection rate of markers for hepatitis B virus (HBV) in the blood samples taken from patients with blood system diseases, by applying the current approaches to examining donated blood and its components for markers of viral infections. The investigation included blood samples from patients with blood system diseases (n=364) and donors (n=5,011). The results of laboratory screening of donated blood samples (n=13,081) were retrospectively analyzed. Commercial kits of reagents were used for immunochemical assay and polymerase chain reaction. Patients with blood system diseases were recorded to have markers of active HBV infection in 12.6% of cases, anti-HBc in 31.3%, and anti-HBs in 37.6%. A retrospective analysis of the results of screening donated blood samples showed the presence of markers for active HBV infection in 0.28% of cases. A prospective examination of blood donors revealed markers of HBV infection in 4.83% of cases, including those of active forms in 0.54% and anti-HBc in 4.79%. The markers of active HBV infection in donors were only anti-HBc IgM in 0.42% of cases. The blood samples from donors with an anti-HBs titer of >200 mIU/ml contained anti-HBc IgM in 10.5%. In the last 5-7 years, the detection rate of markers of HBV infection in the blood samples of patients with blood system diseases have remained at a high level. Screening for decreed markers fails to identify people with inapparent infections among the donors. Even high anti-HBs concentrations in the donated blood may be a risk for HBV transmission by transfusion to a recipient.
Highlights
Impact of current approaches to laboratory screening of donated blood and its components on hepatitis B virus infection in patients with blood system diseases
У доноров крови и ее компонентов aнти-HBc явился наиболее часто выявляемым маркером hepatitis B virus (HBV), как и у пациентов ГНЦ (31,3%), и определялся в 4,79% случаев
Одной из причин высокого уровня встречаемости маркеров HBV у пациентов гематологического стационара является то, что скрининг на декретированные маркеры, независимо от качества тест-систем и оборудования для лабораторной диагностики, не позволяет выявлять скрыто инфицированных лиц среди доноров
Summary
Impact of current approaches to laboratory screening of donated blood and its components on hepatitis B virus infection in patients with blood system diseases. Что положительный результат на aнти-HBc в отсутствие других маркеров HBV может быть следствием неспецифической реакции [26], поэтому для решения вопроса об использовании aнти-HBc-положительных доз крови в клинической практике проводят дополнительно тестирование на уровень анти-HBs. В настоящее время в качестве минимального протективного уровня этих антител у пациентов определена концентрация равная 10 мМЕ/мл [25]. Образцы крови тестировали на молекулярные (ДНК) и серологические (HBsAg, HBeAg, анти-НВс, анти-HBc-IgM, антиHBe) маркеры HBV.
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