南昌地区无偿献血人群HIV-1感染状况及特征分析

Investigation and epidemiological characteristics of HIV-1 infection among voluntary blood donors in Nanchang

目的调查近5年南昌地区无偿献血人群1型艾滋病病毒(HIV-1)感染状况,描述感染者特点,为本地区降低HIV经输血传播风险,制定有效献血者招募及艾滋病防控策略提供数据支持。方法无偿献血者血液标本采用酶联免疫吸附试验(ELISA)方法进行抗-HIV初复检筛查,ELISA初筛阴性标本用核酸检测(NAT)方法检测艾滋病病毒核糖核酸(HIV RNA),抗-HIV或HIV RNA反应性标本用蛋白印迹试验(WB)方法进行确证。统计2014-2018年南昌地区献血者HIV抗体检出率,整理分析HIV-1感染者人口学特征及流行病学资料。结果 2014-2018年南昌地区无偿献血者HIV-1型抗体确证阳性57例,HIV抗体不确定30例,抗体检出率0.018%。ELISA-/NAT+1例,WB鉴定为HIV抗体不确定。57例感染者中,男性占98.25%;21~30岁青年人占40.35%;未婚占64.91%;本科文化占33.33%;本市(县区)户籍占43.86%;高校学生占40.35%;初次献血占75.44%,捐献全血占96.49%;男男同性性传播占52.63%,异性性传播占43.86%;合并梅毒感染占14.04%。HIV-1型抗体阳性标本出现WB特异性条带gp160、gp120、p24均占100%,p66占96.49%,gp41占91.23%,HIV抗体不确定标本出现条带p24占66.67%,gp160占36.67%。结论近5年南昌地区无偿献血人群中HIV-1感染者以初次捐献全血的高校青年男男性行为者(MSM)为主。应采用先进的检测方法和试剂开展HIV筛查,保证血液安全。

Objective To investigate HIV-1 infection among voluntary blood donors in Nanchang area from 2014 to 2018, and understand the characteristics of the infected, so as to reduce the risk of HIV transmission through blood transfusion. Methods Blood samples from voluntary blood donors were screened by ELISA. The screened negative samples were tested for HIV RNA by NAT method, and the positive samples were tested for confirmation by WB method. HIV antibody detection rate of blood donors, the demographic characteristics and epidemiological data were analyzed accordingly. Results From 2014 to 2018, 57 cases of HIV-1 antibody were confirmed positive among voluntary blood donors, 30 cases of HIV antibody were uncertain, and the antibody detection rate was 0.018%, with 1 case of ELISA-/NAT+, and WB identified as HIV antibody uncertain. Among the 57 cases of infection, 98.25% were men;40.35% were young people aged 21-30;64.91% were unmarried;33.33% received undergraduate education;43.86% were local residents;40.35% were college students;75.44% donated blood for the first time and 96.49% donated whole blood. 52.63% were infected via homosexual transmission, and 43.86% via heterosexual transmission. 14.04% had co-infection of TP. WB specific bands gp160, gp120 and p24 were detected in HIV-1 antibody positive specimens, accounting for 100%, p66 for 96.49% and gp41 for 91.23%;Bands p24 and gp160 were 66.67% and 36.67% among HIV antibody uncertain specimens. Conclusion In recent 5 years, the majority of HIV-1 infected people among voluntary blood donors in Nanchang are young, male college students(MSM), with first donation of their whole blood. We should adopt advanced detection methods and reagents to carry out HIV screening to ensure blood safety.