2010-2013年中国南京地区无偿献血人群HBV、HCV、HIV感染情况分析

Infection Status of HBV,HCV and HIV in Voluntary Blood Donors of Chinese Nanjing Area During 2010-2013

本研究在于了解中国南京地区无偿献血者HBV、HCV和HIV感染及分布情况,探讨本地区人群的传染病流行趋势,为献血宣传和招募工作提供指导意见。将2010.6.10-2013.6.9三年间南京地区无偿献血者199777人次的血液标本,采用ELISA法检测HBsAg、抗-HCV和抗-HIV,对三项阴性标本再采用NAT联合检测HBVDNA、HCV-RNA和HIV-RNA,对检测结果进行统计分析,并将抗-HIV初筛反应性标本送南京市疾病预防控制中心确证。结果表明,3年中无偿献血者HBsAg、抗-HCV、抗-HIV感染率分别为0.45%,0.28%,0.11%;NAT呈反应性为0.07%;确证抗-HIV阳性32例,其中男性30例(6例为再次献血者),女性2例;不确定3例,其中男性2例,女性1例。经统计学处理证实,初次献血者与重复献血者HBsAg、抗-HCV、抗-HIV检测不合格率差异有统计学意义。结论:2010.6.10-2013.6.9南京地区无偿献血人群中抗-HCV、抗-HIV阳性率呈逐年下降趋势,HBsAg、NAT检测不合格率随年龄段增加而增加;抗-HCV、抗-HIV检测不合格率随年龄段增加而降低,重复献血者检测不合格率远远低于初次献血者,抗-HIV检测女性酶免检测阳性率高于男性,但确认阳性率男性明显高于女性。因此应提高献血前的征询技巧,重视献血者的招募环节,重点加强初次献血者献血前的征询和评估,加强无偿献血知识的宣传,巩固和发展固定无偿献血者队伍,大力普及NAT检测技术应用于血液筛查,将有效地提高血液安全。

This study was purposed to understand the infection of HBV, HCV, HIV among the voluntary blood donors and the epidemic trend in infectious population in Chinese Nanjing area, and to guide the mobilization and recruitment of blood donors. A total of 199777 whole blood samples of voluntary blood donors were tested by ELISA, the nucleic acid technology （NAT） combined detection （ HBV-DNA, HCV-RNA, HIV-RNA） was added for detection of the samples with HBsAg, anti-HCV, anti-HIV at least unilateral negative donors from June 10,2010 to June 9,2013 years, and these statistic data were analyzed. Every HIV reactive sample（HIV-antibody and/or HIV-RNA） was sent to be confirmed in the Centers for Disease Control and Prevention in Nanjing. The results showed that the voluntary donors＇ infection rate of I-IBsAg, anti-HCV, anti-HIV were 0.45%, 0. 28%, 0. 11% respectively; NAT positive rate was 0.07%, 32 cases were confirmed with anti-HIV positive, in which 30 cases were male （6 cases were repeated blood donors） and 2 cases were female, 3 cases were unconftrmed, in which 2 cases were males and 1 case was female. The statistical analysis demonstrated that the difference of unqualitative rate of HBsAg, anti-HCV, anti-HIV was statistically significant between the ftrst-time and repeated blood donors. It is concluded that the positive rate of anti-HCV and antiHIV displayed a declining trend year by year in Nanjing voluntary blood donation population from June 10,2010 to June 9,2013 years. The unqualitative rate of HBsAg and NAT increased with the age increasing, while that of anti-HCV, anti-HIV decreased with age increasing. The unqualitative rate of the repeated blood donors is far lower than that of the first-time blood donors. The ELISA positive rate of anti-HIV testing in females is higher than that in males, but the confirmed positive rate of male is significantly higher than that of female. Therefore the consulting skills before donating should be improved, concerning the link of recruiting donors, focusing on strengthening the first-time donors＇ consultation, evaluating and developing the fixed voluntary blood donors, and vigorously popularizing NAT technology in blood screening to improve the blood safety effectively.