【摘要】 目的 分析应用单个标本核酸检测(ID-NAT)后，联检反应性鉴别阴性即鉴别非反应性(NDR)且HBsAg-献血者HBV感染状态。方法 将本中心2021年9月—2022年3月的52 608份无偿献血者标本经常规检测和ID-NAT检测后，共检出HBsAg ELISA-TMA核酸检测联检反应性而鉴别非反应性献血者标本(NDR可疑标本)50份。并进行罗氏MPX 2.0单检，采用电化学发光法检测HBV血清学标志物(HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe)。结果 50份HBsAg-NDR可疑标本中确认HBV感染标本11份22%(11/50)。血清学标志物分析：NDR可疑标本中抗-HBc+比例达76%,抗-HBs+占比为44%;HBV感染确认组和未确认组间抗-HBc+(81.8%和74.4%)和抗-HBs+(36.4%和46.2%)的占比，差异无统计学意义(P>0.05),但确认组抗-HBs检测值的分布[中位数14.44 IU/L,范围(10.57～33.74)IU/L]明显低于未确认组。在HBV感染确认组中鉴定出血清学阳性隐匿性乙型肝炎病毒感染者(OBI)10份(90.9%),1份血清学阴性献血者因未能追踪而疑似HBV窗口期感染。结论 HBsAg-NDR可疑标本中仍能检出部分标本为HBV DNA阳性，多种方法联合检测能提高检出率；NDR标本抗-HBc检出率较高，可能存在HBV传播的潜在风险，应提高目前NAT检测灵敏度，确保输血安全性。更多还原

【Abstract】 Objective To analyse the HBV infection status of of non reactive(NDR) and HBsAg blood donors who have a negative identification of reactivity through joint testing, after the Individual nucleic acid detection(ID-NAT).Methods 52 608 blood donors samples from May to December 2021 in our center after routine testing and ID-NAT testing, a total of 50 samples of HBsAg ELISA negative TMA nucleic acid testing initially reactive but discriminatory test non-reactive(the after referred to as NDR samples) were tested.The Roche MPX 2.0 single test was performed, and HBV serological markers(HBsAg, anti-HBs, anti-HBc, HBeAg, anti-HBe) were detected by electrochemiluminescence.Results Among 50 suspected HBsAg NDR specimens, 11 were confirmed to be HBV infected, accounting for 22%(11/50).Serological marker analysis: the proportion of anti-HBc+ was 76%,and that of anti-HBs+ was 44%.The proportion of anti-HBc+(81.8% and 74.4%) and anti-HBs +(36.4% and 46.2%) between HBV infection confirmed group and the unconfirmed group.With no statistical difference(P>0.05),but the distribution of anti-HBs detected values(median 14.44 IU/L,range 10.57～33.74 IU/L) was significantly lower than that in the unconfirmed group.In the HBV infection confirmation group, 10 cases(90.9%) of occult hepatitis B virus infection(OBI) with positive serological results were identified, and one serologically negative blood donor was suspected of HBV window infection due to failure to track.Conclusions Some suspected samples of HBsAg negative NDR can still be detected as HBV DNA positive, and a combination of multiple methods can improve the detection rate.The detection rate of anti HBc in NDR samples is relatively high, which may pose a potential risk of HBV transmission.The current sensitivity of NAT detection should be improved to ensure the safety of blood transfusion.更多还原