2002～2013年邯郸市无偿献血人群HIV筛查及确证情况分析

HIV screening reactive and confirmed positive status of voluntary blood donors in Handan,Hebei from 2002 to 2013,China

目的了解邯郸市无偿献血者HIV感染的情况,便于保障血液安全,降低输血传播HIV的风险。方法献血者抗-HIV初复检采用ELISA方法,有反应性的样本送本市CDC实验室采用WB法进行确证。初筛阳性率统计分析方法采用χ2趋势检验。结果年度间抗-HIV初筛阳性率有降低的趋势（χ2=21.770,P〈0.01）。其中HIV确证感染者24例,年平均感染率为0.36/万,有增加的趋势;感染者大多数为男性（95.8%）;18~40岁占多数（79.2%）;文化程度初、高中者居多;多数是本地户籍（62.5%）;职业以其他（自由职业）和农民居多;感染者主要经性传播,MSM传播多于异性传播;多数为初次献血（75.0%）。WB法确证阳性者均为HIV-1型感染,WB带型全带的占41.7%,gp160、gp120、p41、p24出现率为100%,具有8条以上带型的样本占66.7%;不确定者出现最多的带型为p24（81.7%）。结论检测技术的提高有利于降低假阳性率。HIV感染有增加趋势,具有男性多、年轻化、学历低、职业流动性大的特点。血液安全面临形势严峻,应加强固定献血队伍建设,注重多方面采取措施降低经血传播HIV的风险。

Objective To understand the HIV infection status in voluntary blood donors in Handan in order to facilitate the blood safety and reduce the risk of transfusion-transmitted HIV. Methods ELISA was employed to the initial screening and recheck testing for anti-HIV in blood donors. The reactive samples were sent to CDC for confirmatory test by western blot. Chi-square test was used for the screening positive statistical analysis. Results Screening positive donors has a tendency to reduce by year （χ2 =21. 770,P 〈0. 01 ）. Among them,24 cases are confirmed HIV positive which shows an annual average infection rate of 0.36 per ten thousand. The increasing tendency has been observed. The HIV infected people mostly are men （95.8%） ; 18 to 40 years old （79.2%）, middle and high schools educated; local people （62.5%） ; and the occupation of freelancer and farmers. Most infections are achievedthrough sexual transmission,in which MSM infections are more frequently than heterosexual transmission. The most infected people are first time donors （75.0%）. Western Blot confirmed that all the positive infections are caused by HIV-1. Western Blot with full type was 41.7 %, gp160, gp120, p41, and p24 appeared at arate of 100%. The positive samples with at least eight stripes are occupied 66.7%. The inconclusive results occurred when mostly the stripe of p24 appeared （ 81.7% ）. Conclusion The im-provement of testing technology is helpful to reduce the false positive rate. HIV infection has an increasing tendency, especial- ly in young males with lower education level and more mobile jobs. Although the blood safety is faced with severe situation, the construction of repeat blood donation team, attention of taking measures in many aspects to reduce the risk of HIV blood transmission should be strengthen to ensure the safety of blood utilization.