일개 삼차의료기관 혈액원에서 헌혈자 선별검사로서의 Anti-HBc와 Anti-HBs 검사의 시행 경험
An Experience of the Use of Anti-HBc and Anti-HBs for Blood Donor Screening Tests at a Tertiary Hospital Blood Center in Korea
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
배경 : 본 의료기관 혈액원은 국내 혈액원으로서는 유일하게 anti-HBc와 anti-HBs 검사를 헌혈자 선별검사에 추가로 실 시하였기에 이에 대한 경험을 보고하고자 하였다. 64 임영애∙윤석호 방법 : 2005년 1월부터 2007년 12월까지 혈액관리법에 명시 된 헌혈자 선별검사에 적합한 헌혈자만을 대상으로 anti-HBc 검사를 실시하였다. Anti-HBc 검사가 양성인 경우에는 anti- HBs 검사를 실시하여 음성이면 부적합 헌혈자로 간주하였다. 검사비 산출은 2005년부터 2007년까지 건강보험 요양급여비 용에 제시된 금액으로 연도별로 산정하였다. 결과 : Anti-HBc 양성률은 23.2% (162/699)였으나 연령이 증가함에 따라 증가하였다. 부적합 헌혈자는 전체 헌혈자의 2.7% (19/699), anti-HBc 양성자 중에서는 11.6% (19/162)를 차지하였다. Anti-HBc와 anti-HBs 검사를 위한 비용은 나머 지 헌혈자 선별검사 비용의 약 40%에 해당하였다. 결론 : Anti-HBc와 anti-HBs 추가 실시로 의료기관 혈액 원의 비용 부담이 있었으며 소수의 헌혈자가 추가로 배제되었 으나, 헌혈자가 많지 않으며 30대 이상의 헌혈자가 상대적으로 많았기 때문에 수혈 혈액의 안전성을 확보하기 위한 보조적인 검사로서는 의미가 있었던 것으로 사료된다.
Abstract
Background : The aim of this study was to report the first experience of using tests of antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) for the selection of blood donors in a tertiary hospital blood center in Korea. Methods : From January 2005 to December 2007, the data of all eligible donors according to the Korean Blood Regulation Law were analyzed. Anti-HBc testing was performed in all donors, but anti-HBs was tested only in anti-HBc seropositive donors. Anti-HBs negative but anti-HBc positive donors were regarded as ineligible for blood donation. Cost for donor testing was calculated based on Korean health insurance payment schedule from 2005 to 2007. Results : The seroprevalence of anti-HBc in blood donors was 23.2% (162/699) and increased with increasing age. The proportion of ineligible donors for blood collection was 2.7% (19/699) of total donors and 11.6% (19/162) of anti-HBc seropositive donors. The cost of testing for anti-HBc and anti-HBs was estimated to be about 40% of the total screening cost. Conclusions : Although additional donor screening tests for anti-HBc and anti-HBs requires increased cost and relatively small number of donors are additionally excluded by these tests, they are considered to be helpful for the safety of blood products, because our blood center has characteristics with small number of donors and relatively high percentage of donors in the age group of thirties and older.
참고문헌 (19)
- Blumberg BS, "London WT, Sutnick AI. A serum antigen (Australia antigen) in Down's syndrome, leukemia, and hepatitis", Ann Intern Med, 66, pp.924~931 (1967)
- Okochi K, "Observations on Australia antigen in Japanese", Vox Sang, 15, pp.374~385 (1968)
- Prince AM, "An antigen detected in the blood during the incubation period of serum hepatiti", Proc Natl Acad Sci U S A, 60, pp.814~821 (1968)
- Menitove JE, "Hepatitis, in Scientific basis of transfusion medicine", pp.620~636 (1994), W.B. Saunders Company
- Jung BC, "Prevalence of HBsAg and anti-HCV among Korean blood donors", Korean J Blood Transfus, 5, pp.143~150 (1994)
- Oh DJ, "A study on ALT levels in hepatitis marker positive donors - Anti-HBc positive rate in blood donors", Korean J Blood Transfus, 8, pp.9~17 (1997)
- Oh HB, "Detection rate of hepatitis B virus DNA among blood donors showing HBsAg positivity or negativity and relatedness with other hepatitis B viral marker", Korean J Blood Transfus, 8, pp.249~261 (1997)
- The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005 - Summary -. Final report of project, "Korea Institute for Health and Social Affairs", Ministry of Health & Welfare, Republic of Korea, ~ (2006)
- Schreiber GB, "The risk of transfusion-transmitted viral infections. The Retrovirus Epidemiology Donor Study", N Engl J Med, 334, pp.1685~1690 (1996)
- Song EY, "The frequency of occult infection to Hepatitis B virus in Korean", Korean J Lab Med, 28(S2), pp.S384~ (2008)
- Carman WF, "Fulminant reactivation of hepatitis B due to envelope protein mutant that escaped detection by monoclonal HBsAg ELISA", Lancet, 345, pp.1406~1407 (1995)
- Jongerius JM, "New hepatitis B virus mutant form in a blood donor that is undetectable in several hepatitis B surface antigen screening assays", Transfusion, 38, pp.56~59 (1998)
- Sung H, "Necessity of anti-HBc and anti-HBs screening in Korean blood donation program - study using LG anti-HBc and LG anti-HBs ELISA kit and HBV nucleic acid amplification test -", Korean J Blood Transfus, 12, pp.1~10 (2001)
- Comanor L, "Hepatitis B virus blood screening: unfinished agendas", Vox Sang, 91, pp.1~12 (2006)
- Yugi H, "Hepatitis B virus (HBV) screening strategy to ensure the safety of blood for transfusion through a combination of immunological testing and nucleic acid amplification testing - Japanese experience", J Clin Virol, 36(S1), pp.S56~S64 (2006)
- Joo KR, "Hepatitis B viral markers of Korean adults in the late 1990s : Survey data of 70,347 health screenees", Korean J Gastroenterol, 33, pp.642~652 (1999)
- Current analysis and long term prospects for supply and demand of blood and blood components, "Lim YA", Ministry of Health & Welfare, Republic of Korea, 10~11, pp.A051019 (2005)
- Hollinger FB, "Hepatitis B virus, in Fields Virology. 4th ed", pp.2992~2996 (2001), Lippincott Williams and Wilkins
- Levicnik-Stezinar S, "Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients", J Hepatol, 48, pp.1022~1025 (2008)