广州市2009-2011年无偿献血人群丙型肝炎病毒流行情况及分析

Epidemiological investigation of HCV infection among voluntary blood donors from 2009-2011 in Guangzhou city,China

目的研究广州无偿献血人群中丙型肝炎病毒（HCV）流行情况，了解HCV在广州地区流行趋势，为保障血液安全及制定HCV防控政策提供基础资料。方法选取2009-2011年在广州血液中心无偿献血者中抗-HCV检测双试剂呈反应性的献血员1407人；收集性别、年龄、学历等人口学特征数据，随机抽取HCVRNA阳性者765例分析HCV亚型信息，对3年的结果进行比较。结果2009-2011年广州市无偿献血人群的HCV感染率分别为0．17％、0．21％和0．19％。χ2检验显示：2010年的感染率显著高于2009年（χ2=9．774，P=0．008）；〈20岁年龄组中，2011年HCV阳性率高于2009及2010年（χ2=39．041，P=3．33×10^-9）；20～29岁年龄组中，2010年及2011年HCV阳性率高于2009年（χ2=12．678，P=0．002）；男性HCV阳性率2010年及2011年有所上升（χ2=6．770，P=0．034）；2010年及2011年大学/大专学历者中HCV阳性率较2009年有显著提高（χ2=17．736，P=1．408×10^-8）。广州地区流行的HCV亚型主要为HCV1b和HCV6a，3年间的亚型分布无明显变化（P=0．153）。结论广州地区献血人群的HCV阳性率处于较低水平，但30岁以下、男性、大学／大专文化程度的献血者中HCV阳性率有上升的趋势，需加强对HCV的宣教和防控工作。

Objective To study the epidemiologic features of hepatitis C virus （HCV） infection among volun- tary blood donors in Guangzhou, China from 2009 to 2011. Methods A retrospective study was conducted on 1 407 voluntary blood donors with HCV positive from 2009 to 2011 at the Guangzhou Blood Center of China. Donated blood samples were screened for HCV antibodies using two enzyme-linked immunosorbent assays （ELISA） . HCV genotypes were determined for 765 randomly selected HCV RNA positive blood samples and further epidemiologic analysis was performed. Results Of all voluntary blood donors, the HCV infection was 0.17%, 0.21% and 0.19% for year 2009, 2010 and 2011, respectively, with a significant higher rate in 2010 than in 2009 （χ2 =9. 774, P=0. 008） . A higher infection rate was observed in donors under the age of 20 in 2011 compared to that in 2009 and 2010 （χ2=39.041, P=3.33×10^-9） . HCV infection was higher in the 20-30 age group in both years 2010 and 2011 than that in 2009 （χ2=12.678, P=0. 002）. HCV infectionwas increased from 2010 to 2011 among male blood donors （χ2=6. 770, P=0. 034） and among donors with college educations （χ2 = 17. 736, P= 1. 408 ）×10^-4 ） . HCV lb and 6a were the predominant subtypes in Guangzhou, China. HCV lb accounted for 43.0%, 46.9% and 39.0% of all HCV isolates for years 2009, 2010 and 2011, while the HCV 6a subtype was detected at 41.0%, 29.6%and 39.0% in these 3 years, re- spectively. HCV subtype distribution remained stable during 2009--2011 （P=0. 153）. Coneluslons The prev- alence of HCV in voluntary blood donors remained relatively low from 2009 to 2011 in Guangzhou, China. However, significant rising trends were observed among male blood donors, those under 30 years old, and donors with a college education.