输血传播隐性乙型肝炎病毒感染的生物标志物:进展如何?

IF 9 2区 医学 Q1 VIROLOGY Reviews in Medical Virology Pub Date : 2024-03-01 DOI:10.1002/rmv.2525
Michael X Fu, Peter Simmonds, Monique Andersson, Heli Harvala
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引用次数: 0

摘要

输血是一项重要的程序,其中乙型肝炎病毒(HBV)的输血传播感染仍是一个重要问题,尤其是来自隐性乙型肝炎病毒感染(OBI)献血者的感染。隐匿性乙型肝炎病毒感染是一个复杂的实体,需要使用肝内病毒转录活性的代用血液生物标志物进行检测,因此需要不断完善用于筛查的一系列检测方法。本综述旨在批判性地评估当前血液生物标志物的最新进展,以指导确定 OBI 献血者,并讨论可在未来诊断实践中引入的新型 HBV 标志物。由于在检测低水平 HBV 表面抗原、突变体和复合物方面存在挑战,因此有必要采用超灵敏的多价解离测定法,而 HBV DNA 检测需要提高灵敏度,但却增加了不可及性。抗核心抗体检测几乎可以推迟所有潜在感染性捐献,但特异性较低,而防止感染的抗表面抗体滴度定义不清,灵敏度也不理想。这些传统的血液 HBV 标志物所面临的挑战使我们急需能帮助我们更好地了解 OBI 的替代生物标志物。新出现的病毒生物标记物,如前基因组 RNA 和 HBV 核心相关抗原、T 细胞反应性和细胞因子水平等免疫学 HBV 生物标记物,以及微 RNA 和人类白细胞抗原分子等宿主生物标记物,为更准确地评估肝内活动提供了潜在的进展。对这些标志物的进一步研究可能会发现一种利用各种新型和传统血液 HBV 标志物定量的 OBI 最佳诊断算法。解决本综述中发现的关键知识缺口将降低输血传播 HBV 感染的残余风险,同时又不影响血液供应的可持续性。
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Biomarkers of transfusion transmitted occult hepatitis B virus infection: Where are we and what next?

Blood transfusion is a vital procedure, where transfusion-transmitted infection of hepatitis B virus (HBV) remains an important issue, especially from blood donors with occult hepatitis B virus infection (OBI). Occult hepatitis B virus infection is a complex entity to detect using surrogate blood biomarkers for intrahepatic viral transcriptional activity, requiring a continually refined battery of tests utilised for screening. This review aims to critically evaluate the latest advances in the current blood biomarkers to guide the identification of OBI donors and discuss novel HBV markers that could be introduced in future diagnostic practice. Challenges in detecting low HBV surface antigen levels, mutants, and complexes necessitate ultrasensitive multivalent dissociation assays, whilst HBV DNA testing requires improved sensitivity but worsens inaccessibility. Anti-core antibody assays defer almost all potentially infectious donations but have low specificity, and titres of anti-surface antibodies that prevent infectivity are poorly defined with suboptimal sensitivity. The challenges associated with these traditional blood HBV markers create an urgent need for alternative biomarkers that would help us better understand the OBI. Emerging viral biomarkers, such as pre-genomic RNA and HBV core-related antigen, immunological HBV biomarkers of T-cell reactivity and cytokine levels, and host biomarkers of microRNA and human leucocyte antigen molecules, present potential advances to gauge intrahepatic activity more accurately. Further studies on these markers may uncover an optimal diagnostic algorithm for OBI using quantification of various novel and traditional blood HBV markers. Addressing critical knowledge gaps identified in this review would decrease the residual risk of transfusion-transmitted HBV infection without compromising the sustainability of blood supplies.

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来源期刊
Reviews in Medical Virology
Reviews in Medical Virology 医学-病毒学
CiteScore
21.40
自引率
0.90%
发文量
88
期刊介绍: Reviews in Medical Virology aims to provide articles reviewing conceptual or technological advances in diverse areas of virology. The journal covers topics such as molecular biology, cell biology, replication, pathogenesis, immunology, immunization, epidemiology, diagnosis, treatment of viruses of medical importance, and COVID-19 research. The journal has an Impact Factor of 6.989 for the year 2020. The readership of the journal includes clinicians, virologists, medical microbiologists, molecular biologists, infectious disease specialists, and immunologists. Reviews in Medical Virology is indexed and abstracted in databases such as CABI, Abstracts in Anthropology, ProQuest, Embase, MEDLINE/PubMed, ProQuest Central K-494, SCOPUS, and Web of Science et,al.
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