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。本文主要对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。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 provides an overview of OBI's concept, serological characteristics, genomic features, pathogenesis mechanisms, epidemiological characteristics, and advances in detection strategies.
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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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