Evaluation of repeated testing with blood screening platform in confirmation of NAT non-discriminatory reactive samples
10.13303/j.cjbt.issn.1004-549x.2026.04.007
- VernacularTitle:血液核酸筛查平台的重复检测对NAT NDR确认的价值评估
- Author:
Mengfan LI
1
;
Xuelian DENG
2
;
Liang ZANG
2
;
Lei ZHOU
2
;
Xiaochun LIU
2
;
Xiaohua LIANG
2
;
Lunan WANG
3
Author Information
1. College of Medical Laboratory, Dalian Medicine University, Dalian 116044, China
2. Dalian Blood Center, Dalian 116001, China
3. National Center for Clinical Laboratories, Beijing Hospital, National Center for Gerontology; National Clinical Research Center for Gerontology; The Key Laboratory of Geriatrics of NHC; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
blood screening;
nucleic acid testing;
occult hepatitis B virus infection (OBI);
HBV DNA/confirmation;
anti-HBc
- From:
Chinese Journal of Blood Transfusion
2026;39(4):458-464
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate repeated testing on blood screening platforms in confirmation of non-discriminatory reactive (NDR) samples in nucleic acid testing (NAT). Methods: A total of 102 HBsAg-negative/NAT NDR samples were collected from voluntary blood donors at Dalian Blood Center between January 2021 and December 2023. Repeated testing was performed using two NAT platforms (Cobas s201 and Panther). For the first round of repeated testing, all samples were tested 12 times on each system; for the second round, the samples which were non-reactive or only reactive once in the first round were tested an additional 8 times. Anti-HBc and anti-HBs was detected using electrochemiluminescence assay (ECA). Meanwhile, blood donors were followed up. Results: The proportion of anti-HBc+ in 102 NDR samples was 88.2%. Forty-one samples (40.2%, 41/102) and 7 samples were confirmed HBV DNA+ in first-round and second-round repeated testing, respectively. The cumulative confirmation rate of HBV DNA+ was 47.1% (48/102) after repeated testing. Extra five blood donors detected HBV DNA+ in follow-up were identified as anti-HBc+ occult hepatitis B virus infection (OBI), while no window period infection was observed. Ultimately, there were 53 HBV infected donors confirmed, 46 HBV infection-unconfirmed, and 3 HBV uninfected. No significant difference was observed between the confirmation rate of the first-round testing and the cumulative confirmation rate after the second-round testing (P>0.05). The proportion of anti-HBc+ donors was quite high in both HBV infection-confirmed (98.1%) and unconfirmed group (82.6%), and donors with seronegative and anti-HBs-only occupied a high proportion in the latter (P<0.05). Conclusion: Numerous repeated testing of NDR samples using NAT platforms cannot achieve complete confirmation of HBV infection. Supplementary anti-HBc testing can minimize potential OBI risk among NDR donors, and is low-cost and efficient.
