Prevalence of HBV DNA in Packed Red Blood Cells

적혈구 농축제재에서 HBV DNA의 노출정도

Assays for HBsAg, HBV DNA, anti-HBc and anti-HBs of 285 units of packed red blood cells supplied by Taegu Red Cross Blood Center were performed to evaluate the correlation between the prevalence of HBV DNA and the serologic markers for hepatitis B virus. None of 285 plasma samples was positive for HBsAg, however, HBV DNA were detected by polymerase chain reaction in 2 samples which both presented only with anti-HBc positivity. Of 204 samples tested for anti-HBs, 96 samples(47.1%) were positive and among 216 samples tested for anti-HBc, 80 samples(37.0%) were positive. Of 193 samples tested for both anti-HBs and anti-HBc, 80(41.1%) were all negative and 48(24.9%) were positive on both tests. Those samples which showed positivity only to anti-HBc were 25(13.0%). Considering the above results, transfusion-transmitted hepatitis B virus infection could be prevented by discarding anti-HBc positive blood, however, that may bring insufficient supply of donor bloods in the country like Korea where the prevalence of anti-HBc is high. Anti-HBc positive blood unequivocally positive for anti-HBs should be considered noninfectious for HBV and should be allowed to be transfused. It would reduce the amount of discarding donor blood as the routine blood donor screening tests presently used at Korea Red Cross Blood Center supplemented by anti-HBs and anti-HBc testing.

수혈 후 B형 간염 바이러스의 전파를 감소시키기 위한 방법으로 현재 적십자 혈액원에서 공급되는 적혈구 농축제재를 대상으로 HBV DNA, HBsAg, anti-HBs 및 anti-HBc를 측정 하여 수혈자에서 HBV DNA의 노출정도와 HBV DNA와 B형 바이러스 간염의 혈청학적 표지자와의 관련성을 조사하여 다음과 같은 결과를 얻었다. 대구 적십자 혈액원에서 공급되는 적혈구 농축제재에서는 HBsAg이 검출되지 않았으며, HBV DNA는 0.6%에서 검출되었는데, 모두 anti-HBc만 양성인 경우였다. Anti-HBc양성률은 37%였으며, 이들중 65.8%에서 anti-HBs도 양성으로 나타나 anti-HBc만 양성인 경우는 공혈혈액의 13.0% 정도로 추정되었다. 따라서, 우리나라와 같이 anti-HBc양성률이 높은 지역에서는 anti-HBs를 추가하는 경우 13%의 혈액제제만을 폐기함으로써 HBV DNA의 전파를 차단시킬수 있으리라 생각되며 현재 실시하고 있는 검사보다 예민도와 특이도가 높은 선별검사의 개발이 필요한 것으로 생각된다.