受血者受血前HIV、HBV、HCV、梅毒感染及其重叠感染研究

Infection and co-infection of human immunodeficiency virus,hepatitis B virus,hepatitis C virus and syphilis in recipients before transfusion

目的研究受血者受血前人免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、梅毒感染及其重叠感染现状与特点。方法对2007年10月-2008年6月间某院需输注血制品的9694例患者进行检测；采用酶联免疫吸附试验检测血清HBV标志物、血清抗HCV，双抗原夹心酶联免疫法检测血清抗HIV和梅毒抗体。结果9694例受血者受血前血清HBV标志物阳性1549例（15．98％），抗HCV阳性59例（0．61％），抗HIV阳性34例（0．35％），梅毒抗体阳性495例（5．11％）。重叠感染者中，HBV与HCV57例（0．59％），HBV与梅毒94例（0．97％），HCV与梅毒3例（0．03％）；血清抗HIV阳性患者中，重叠感染HBV13例（0．13％），HCV10例（0．10％），梅毒4例（0．04％）；HIV、HBV和HCV重叠，HIV、HBV和梅毒重叠感染各2例（1．08％），HIV、HBV、HCV和梅毒重叠感染1例（0．54％）。结论部分受血者在受血前就已有感染，特别是HBV和梅毒的感染率较高。对受血者于受血前进行全面检查不仅可避免相关医疗纠纷，还可为患者治疗和医务人员的职业防护提供帮助。

Objective To investigate the condition and characteristics of infection and co-infection of human immunodeficiency virus （HIV）, hepatitis B virus （HBV）, hepatitis C virus （HCV） and syphilis before transfusion. Methods 9 694 cases of transfusing recipients in a hospital between October, 2007 and June, 2008 were detected; Serum HBV markers, anti-HCV were detected by enzyme linked immunosorbent assay （ELISA） ; Serum anti-HIV, anti-syphilis were detected by double-sandwich ELISA（DS-ELISA）. Results Among 9 694 transfusing recipients, the positive rate of HBV marker before receiving transfusion was 15.98% （1 549 cases）, the positive rate of anti- HCV, anti-HIV and anti-syphilis was 0. 61% （59 cases）, 0. 35% （34 cases） and 5.11% （495 cases） respectively. The co-infection rate of HBV and HCV was 0. 59% （57 cases）, the co-infection rate of HBV and syphilis was 0. 97% （94 cases）, the co-infection rate of HCV and syphilis was 0. 03% （3 cases） ; Among patients with HIV positive, the co-infection rate with HBV, HCV and syphilis was 0. 13%（13 cases）, 0. 10%（10 cases） and 0. 04% （4 cases） respectively; The co-infection rate of HIV, HBV and HCV was 1. 08% （2 cases）, the co-infection rate of HIV, HBV and syphilis was 1.08%（2 cases）, co-infection rate of HIV, HBV, HCV and syphilis was 0. 54%（1 case）. Conclusion Some recipients have infection before transfusion, especially HBV and syphilis infection. The over-all examination on recipients not only can avoid medical dispute, but also improve clinical therapy for patients and health care workers occupation safety protection.