Study On The Correlation Between ALT Test And Other Screening Tests In Blood Donation Of Nang Chang From 2015 To 2016

Background: As we all know,glutamyl alanine transferase(ALT)is a sensitive indicator of early hepatitis,the international first proposed as an alternative to hepatitis testing experiments,used in unpaid blood donors,the Chinese "blood donors Health check requirements " GB18467 set ALT as one of the indicators of blood donors screening.With the advent of Nucleic acid amplification testing(NAT)and the continuous updating of Enzyme-linked immunosorbent assay(ELISA),the adjuvant effect of ALT on screening hepatitis and the high blood scrapping rate,countries began to question the significance of ALT in this test indicators in the unpaid blood donation.Objective: To study the association between ALT and other indicators and to reveal the significance of ALT in blood donation in Nanchang,Jiangxi Province.Through the current detection mode,the blood donors were screened and analyzed,which provided the reference for future blood donation screening.Methods: The blood donors of Nanchang area in Jiangxi province were 58817 and 59348 in the whole year of 2015 and 2016,respectively.The ALT tested by rate method and HBsAg,anti-HCV,Anti-HIV and anti-TP test detected by ELISA.when the five indicators of blood donors were qualified,then choose the six samples of mixed NAT,positive and then single-mixed test.Result:1)The total failure rate was 2.38% and 2.18% respectively in 2015 and 2016.The failure rate of ALT in blood donors was 1.17% and 0.90% respectively.The failure rate of HBsAg was 0.56% and 0.54%,and the anti-HCV failure rate was 0.12% and 0.20%,The failure rate of anti-HIV was 0.06% and 0.09%,the anti-TP failure rate was 0.38% and 0.33%,and the NAT failure rate was 0.09% and 0.11%.There were significant differences between the total failure rate and the ALT failure rate between 2015 and 2016,which was statistically significant(P <0.05)2)The number of HBV DNA positive was 53 cases(0.9%)in 2015,68 cases(0.11%)in 2016,and the OD value of HBs Ag was divided into 0.010,0.011-0.030,0.031-0.060 and 061-0.080,the composition failure ratio was 83%,7.5%,7.5% and 3.8% in 2015,respectively,77.9%,11.8%,7.4% and 2.9% in 2016.The number of HBV DNA positive was not increased with the rise of HBsAg OD value.For HBV DNA positive specimens in HBsAg OD value bellow 0.010,44 cases in 2015,2016 53 cases,retrospective analysis of ALT values,divided into 0-12 U / L,13-25 U / L,26-38 U / L,39-50 U / L four groups,the composition failure ratio of 2015 followed by 20.5%,34.1%,34.1%,11.3%;2016 followed by 24.5%,49.1%,17.0%,9.4%.HBV DNA positive samples with HBsAg OD values below 0.010 were found and did not increase with the rise of ALT value;The ALT values of HBV DNA positive samples were above the normal range of 80-90%.3)The number of HBV DNA postive were divided into four groups according to the Ct values,below 32,32-36,37-41 and 41,and the positive proportion of the four group was 7.5%,43.5%,41.5% and 7.5% in 2015;13.2%,51.5%,33.8% and 1.5% in 2016.It was found that the distribution of Ct values of HBV DNA positive in 2015 was similar to the distribution in 2016,The main percent(more than 85%)distributed between Ct 32-41.4)In 2015 and 2016 blood donation population can be divided into the ALT,qualified and the unqualified people and serological markers fraction defective is compared.The results showed that there was no significant difference in HBsAg,anti-HCV,anti-HIV,anti-TP and NAT failure rates between ALT qualified population and unqualified population,P> 0.05;and anti-HCV,anti-HIV failed rate of ALT qualified population in 2016 was significantly higher than that of 2015.There was no significant difference in ALT rate between the positive hepatitis group and the negative hepatitis group in 2015 and 2016.Conclusion:1)To strengthen precautions before blood donation to avoid the physiological factors caused by elevated ALT value,to strengthen the flow of blood spots ALT screening test,can significantly reduce the ALT check failure rate.2)ALT normal and seroneous specimens,there is still the possibility of HBV DNA positive;review analysis of ALT and HBsAg OD value,indicating that ALT in the role of hepatitis virus infection is reduced,the choice of specificity,higher sensitivity of nucleic acid detection technology can effectively prevent the leakage of enzyme technology.3)ALT qualified population can be combined HBsAg,anti-HCV,anti-HIV and anti-TP unqualified,or combined with a number of unqualified;and 2016 ALT qualified population of hepatitis C infection rate and HIV infection rate increased significantly than in 2015.