Clinical and epidemiological profile of female blood donors with positive serology for viral hepatitis B

ABSTRACTINTRODUCTION:Since women are frequently the minority among blood donors worldwide, studies evaluating this population usually reflect male features. We assessed the features of female blood donors with positive serology for HBV and compared them with those of men.METHODS The study comprised consecutive blood donors referred to a specialized liver disease center to be evaluated due to HBsAg- and/or anti-HBc-positive tests.RESULTS: The study encompassed 1,273 individuals, 219 (17.2%) of whom were referred due to positive HBsAg test and 1,054 (82.8%) due to reactive anti-HBc test. Subjects' mean age was 36.8±10.9 years, and 28.7% were women. Female blood donors referred for positive HBsAg screening tests demonstrated higher prevalence of healthcare workers (9.3% vs 2.5%) and lower prevalence of sexual risk behaviors (15.1% vs 41.1%) and alcohol abuse (1.9% vs 19.8%) compared to men. Women had lower ALT (0.6 vs 0.8×ULN), AST (0.6 vs 0.8×ULN), direct bilirubin (0.2 vs 0.3mg/dL), and alkaline phosphatase (0.5 vs 0.6×ULN) levels and higher platelet count (223,380±50,293 vs 195,020±53,060/mm3). Women also had a higher prevalence of false-positive results (29.6% vs 17.0%). No differences were observed with respect to liver biopsies. Female blood donors referenced for reactive anti-HBc screening tests presented similar clinical, epidemiological, and biochemical characteristics to those reported for positive HBsAg screening tests and similarly had a higher prevalence of false-reactive results.CONCLUSIONS: Compared to men, female blood donors with positive HBsAg and/or anti-HBc screening tests demonstrated higher prevalence of professional risk and false-positive results and reduced alteration of liver chemistry.

摘要及引言：全球范围内女性献血者常为少数群体，针对该群体的相关研究往往更多反映男性献血者的特征。本研究针对血清学检测呈乙型肝炎病毒（HBV）阳性的女性献血者特征展开评估，并与男性献血者进行对比。
方法：本研究纳入因乙型肝炎表面抗原（HBsAg）和/或乙型肝炎核心抗体（anti-HBc）检测呈阳性，被转诊至专科肝病中心接受评估的连续入组献血者。
结果：本研究共纳入1273名研究对象，其中219例（17.2%）因HBsAg检测阳性被转诊，1054例（82.8%）因anti-HBc检测呈反应性被转诊。研究对象的平均年龄为36.8±10.9岁，女性占比28.7%。相较于男性，因HBsAg筛查呈阳性转诊的女性献血者中，医护人员占比更高（9.3% vs 2.5%），性风险行为（15.1% vs 41.1%）与酒精滥用（1.9% vs 19.8%）的发生率更低。女性的谷丙转氨酶（ALT）、谷草转氨酶（AST）、直接胆红素、碱性磷酸酶水平均更低，具体数值分别为0.6 vs 0.8×正常上限（upper limit of normal, ULN）、0.6 vs 0.8×ULN、0.2 vs 0.3mg/dL、0.5 vs 0.6×ULN；血小板计数更高，为223380±50293 vs 195020±53060/mm³。女性假阳性结果的发生率也更高（29.6% vs 17.0%）。两组的肝活检结果无显著差异。因anti-HBc筛查呈反应性转诊的女性献血者，其临床、流行病学及生化特征与HBsAg筛查阳性的女性献血者相似，且同样具有更高的假反应性结果发生率。
结论：与男性献血者相比，HBsAg和/或anti-HBc筛查呈阳性的女性献血者，其职业风险与假阳性结果的发生率更高，而肝脏生化指标异常程度更低。