Infection Mechanism and Detection of Occult Hepatitis B Virus in Voluntary Blood Donors
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摘要: 发生输血后肝炎（post transfusion hepatitis，PTH）的风险主要来自于输入HBsAg阴性的HBV感染血液，即血清学窗口期（window period，WP）和隐匿性HBV感染（occult HBV infection，OBI）。其中，OBI是一种低病毒复制的HBV，因此成为了乙肝病毒感染防治的难点，也是输血后肝炎的重要传染源之一。虽然通过核酸检测技术（nucleic acid test，NAT）能一定程度上减少输血后肝炎发生，但有部分OBI感染者在献血者中存在，是HBV经血传播的潜在风险。对OBI的概念、血清学特征、基因组特征、发生机制、流行病学特点和检测策略进展进行概述，为OBI人群血液制品的采集、质量控制、安全使用等提供参考。Abstract: The risk of post-transfusion hepatitis （PTH） primarily stems from blood transfusion containing HBV-infected blood that is HBsAg-negative, specifically during the serological window period （WP） and occult HBV infection （OBI）. OBI is a low viral replication form of HBV, making it a challenge in hepatitis B virus infection prevention and control, and a significant transmission source of post-transfusion hepatitis. Although nucleic acid testing （NAT） can reduce the occurrence of post-transfusion hepatitis to some extent, some OBI-infected individuals exist among blood donors, representing a potential risk of HBV transmission through blood. This article primarily summarizes an overview of OBI's concept, serological characteristics, genomic features, pathogenesis mechanisms, epidemiological characteristics, and advances in detection strategies, to provide theoretical basis for the collection, quality control and safe use of blood products for the OBI population.
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图 1 宿主细胞与乙肝病毒相互作用机制示意图（用BioRender网站自制）
Figure 1. Schematic diagram of the interaction mechanism between host cells and hepatitis B virus（Created in BioRender.com）
表 1 不同NAT检测技术性能对比
Table 1. Performance comparison of different NAT detection technologies
维度 灵敏度 检测速度 检测优势 成本效益 血液筛查 TMA 高 快（等温） RNA病毒 较高 单样本检测 PCR 受限于试剂 较慢（热循环） DNA病毒，RNA需逆转录 适合常规筛查 混样检测 
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