İzole anti-HBc pozitif olgularda HBV-DNA varlığının araştırılması ve bu olgularon kan bankacılığı açısından önemi
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Date
2009-04
Authors
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Publisher
Ankara Mikrobioloji Derneği
Abstract
Hepatit B virusu (HBV)’nun transfüzyonla geçişi günümüzde önemli ölçüde azalmış olsa da transfüzyon tıbbının en önemli sorunlarından birisi olmaya devam etmektedir. Yapılan çalışmalar, HBsAg negatif
donörlerden yapılan transfüzyonlar ile HBV bulaşı olabildiğini göstermektedir. Bu çalışmada, HBsAg negatif kan donörü serumlarında anti-HBc, anti-HBs ve HBV-DNA pozitifliklerinin araştırılması ve ülkemizde
uygulanmakta olan donör tarama testlerinde bir düzenlemenin gerekip gerekmediği konusundaki tartışmalara ışık tutacak bir veri oluşturulması amaçlanmıştır. Çalışmaya HBsAg negatif 9282 kan bağışçısının
serumu dahil edilmiş; HBsAg, anti-HBc ve anti-HBs testleri ticari ELISA kitleriyle (Orto-Clinical Diagnostics, Vitros, Brezilya), HBV-DNA testi ise gerçek zamanlı PCR (QIAGEN, Artus 3000, Almanya) yöntemiyle çalışılmıştır. Çalışmamızda HBsAg negatif donörlerin %18 (1679/9282)’i anti-HBc pozitif bulunmuş;
bunların 1504 tanesinde anti-HBs çalışılmış ve 225 (%15)’i negatif olarak saptanmıştır. İzole anti-HBc pozitif olan (HBsAg negatif, anti-HBc pozitif, anti-HBs negatif) 225 serumun 218’inde HBV-DNA araştırılmış
ve 1 (%0.45)’inde pozitiflik belirlenmiştir. Serum yetersizliği nedeniyle çalışılamayan örnekler değerlendirme dışı bırakılarak, sonuçlar toplu olarak irdelendiğinde, bölgemizdeki kan bağışçılarının %2.5
(225/9107)’inde izole anti-HBc pozitifliği ve %0.011 (1/9100)’inde HBsAg negatifliğine rağmen HBVDNA pozitifliği bulunduğu saptanmıştır. Bu durumda, yılda ortalama 21.000 kan bağışı yapılan merkezimizde HBsAg negatif bağışçılar aracılığıyla HBV bulaşı 2.3 hasta/yıl olarak hesaplanabilir. Sonuç olarak
kan bankalarında rutin HBsAg taramalarına rağmen düşük oranda da olsa HBV-DNA pozitifliği nedeniyle
HBV geçişi olabileceği unutulmamalıdır
Despite the decrease in transfusion-transmitted hepatitis B virus (HBV), it is still one of the main problems in transfusion medicine. Recent studies have shown that HBV is transmissible to recipients from HBsAg negative donations. This study was aimed to detect anti-HBc, anti-HBs and HBV-DNA positivity in HBsAg negative cases and to determine whether a reconsideration is required for HBV screening policies in blood banking. In this study, anti-HBs and anti-HBc total was investigated in 9282 HBsAg negative donor samples by commercial ELISA (Orto-Clinical Diagnostics, Vitros, Brazil) system and HBV-DNA by real-time PCR method (QIAGEN, Artus 3000, Germany). In 9282 HBsAg negative samples, anti-HBc positivity rate was 18% (1679/9282). Anti-HBs negativity was detected in 15% (n= 225) of these anti-HBc positive sera. Among the isolated anti-HBc positive (HBsAg negative, anti-HBc positive, anti-HBs negative) 225 serum samples 218 were investigated for HBV-DNA presence and one sample was found to be positive (0.45%). When the samples not tested due to insufficient serum amount were excluded, the total rate of isolated anti-HBc positivity in the study region was 2.5% (225/9107) and HBV-DNA positivity in the HBsAg negative group was 0.011% (1/9100). The annual number of blood donations in our center was about 21.000, thus the rate of HBV transmission from HBsAg negative donors could be estimated as 2.3 patients/year. Although the rate of HBV transmission due to HBV-DNA positivity among HBsAg negative blood donors is low, this risk should always be kept in mind in transfusion medicine.
Despite the decrease in transfusion-transmitted hepatitis B virus (HBV), it is still one of the main problems in transfusion medicine. Recent studies have shown that HBV is transmissible to recipients from HBsAg negative donations. This study was aimed to detect anti-HBc, anti-HBs and HBV-DNA positivity in HBsAg negative cases and to determine whether a reconsideration is required for HBV screening policies in blood banking. In this study, anti-HBs and anti-HBc total was investigated in 9282 HBsAg negative donor samples by commercial ELISA (Orto-Clinical Diagnostics, Vitros, Brazil) system and HBV-DNA by real-time PCR method (QIAGEN, Artus 3000, Germany). In 9282 HBsAg negative samples, anti-HBc positivity rate was 18% (1679/9282). Anti-HBs negativity was detected in 15% (n= 225) of these anti-HBc positive sera. Among the isolated anti-HBc positive (HBsAg negative, anti-HBc positive, anti-HBs negative) 225 serum samples 218 were investigated for HBV-DNA presence and one sample was found to be positive (0.45%). When the samples not tested due to insufficient serum amount were excluded, the total rate of isolated anti-HBc positivity in the study region was 2.5% (225/9107) and HBV-DNA positivity in the HBsAg negative group was 0.011% (1/9100). The annual number of blood donations in our center was about 21.000, thus the rate of HBV transmission from HBsAg negative donors could be estimated as 2.3 patients/year. Although the rate of HBV transmission due to HBV-DNA positivity among HBsAg negative blood donors is low, this risk should always be kept in mind in transfusion medicine.
Description
Keywords
Anti-HBc, HBV-DNA, Transfusion, Hepatitis-b-virus, Transfusion, Infection, Donors, Donations, Safety, Transmission, Titer, Risk, Nat, Microbiology, Kan donörü, Transfüzyon, HBsAg tarama, Anti-HBc, HBV-DNA
Citation
Bal, S. H. vd. (2009). "İzole anti-HBc pozitif olgularda HBV-DNA varlığının araştırılması ve bu olgularon kan bankacılığı açısından önemi". Mikrobiyoloji Bülteni, 43(2), 243-250.