无症状乙型肝炎病毒感染者配偶献血潜在输血风险评估OA

Objective To investigate the incidence of occult hepatitis B virus infection(OBI)in spouses of asympto-matic hepatitis B virus(HBV)infected individuals in Shenzhen,China,and to analyze their serological and molecular char-acteristics and possible transmission routes,so as to propose refined strategies for blood safety.Methods After rapid screening for HBsAg at the blood collection sites,samples from HBsAg-positive blood donors and their concurrently donating spouses were collected.All samples were tested for hepatitis B serological markers by electrochemiluminescence immunoas-say(ECLI).Simultaneously,HBV nucleic acid extractiona,nested PCR amplification,gene sequencing of S and BCP/PC regions and qPCR were conducted.Results A total of 112 samples were collected,including 56 from HBsAg positive do-nors and 56 from their spouses.All donors were confirmed as HBsAg+/DNA+/anti-HBc+,indicative of asymptomatic chro-nic hepatitis(CHB)infection.Among their 56 spouses,11(19.6%)were identified as HBV DNA+.The prevalence was higher in males(23.1%)than in females(16.7%).Six spouses(10.8%)had OBI,three of whom(5.4%)were nega-tive in routine blood screening tests.The residual risk of HBV were estimated as 1∶127(95%CI,1∶356 to 1∶66).Among infected couples,immune escape mutation(E164D)and glycosylation mutations(I126T and T131N/M133T)were identi-fied.Furthermore,sequence analysis suggested partner-to-partner transmission in eight cases.Conclusion A substantial proportion(19.6%)of spouses of asymptomatic HBV infected donors were HBV-positve,with an OBI prevalence of 10.9%.Among these,5.4%were negative in routine tests.To ensure blood safety,we recommend that spouses of HBV infected in-dividuals be deferred from blood donation.