无偿献血HIV抗体初筛阳性确认结果分析

Analysis on positive confirmation result of HIV antibody prelimicnary screening in voluntary blood donation

目的分析2009~2015年HIV抗体筛查和确证试验结果,为制订在低危人群中招募献血者的招募策略和献血者回归提供依据。方法采用酶联免疫吸附试验（ELISA）检测HIV抗体,分别用2个不同厂家试剂检测。HIV抗体检测阳性或可疑的标本送深圳市疾病预防控制中心进行免疫蛋白印迹确认。选取2009~2015年血液标本筛查确认结果进行统计分析。结果2009~2015年197 766份血液标本,2009~2015年每年总的感染率分别为1.3/10万、4.7/10万、5.6/10万、5.4/10万、5.3/10万、4.6/10万、7.3/10万,平均感染率为0.004 9%（4.9/10万）,平均确诊阳性率为22.1%,假阳性率为77.9%。HIV抗体确认阳性的献血者中年龄18~30岁的占67.7%。结论重视献血前的征询招募工作,针对外来劳务工和文化程度相对低的献血者加强献血知识的普及,特别是有高危行为的献血者,采用小卡片的方式,引导其到疾控中心做专业的咨询检测,既提高输血安全系数又能预防艾滋病扩散。针对假阳性的献血者做好回访跟踪监测及献血资格的回归工作,减少献血者的流失。选择更加灵敏的试剂及选择更加灵敏的病毒核酸扩增的方法,可尽量缩小因窗口期感染的风险,确保输血安全。

Objective To analyze the screening and confirmation test results of human immunodeficiency virus（HIV）antibody during 2009-2015 to provide the basis for the recruiting strategies in recruiting blood donors among the low risk population and blood donor′s returning to the team.Methods The blood samples of voluntary blood donors were detected the HIV antibody by the ELISA method,with the reagents provided by 2different manufacturers.The samples of HIV antibody positive or suspected samples were submitted to the Shenzhen Municipal Center for Disease Control and Prevention CDC for conducting the Western blot confirmation.The confirmation results of blood samples during 2009-2015 were statistically analyzed.Results There were197 766 blood samples from 2009 to 2015.The overall infection rates of HIV were 1.3,4.7,5.6,5.4,5.3,4.6,7.3/one hundred thousand respectively,the average infection rate was 0.004 9%（4.9/one hundred thousand）,the average confirmed positive rate was 22.1%,the false positive rate was 77.9%.Among the blood donors of confirmed positive HIV antibody,the donors aged 18-30 years old accounted for 67.7%.Conclusion It is important for the recruitment work before the blood donation.Aiming at the blood donors of workers from outside and relative low cultural level,especially the blood donors of high risk behavior,the small card mode could be adopted to guide them to the disease control center to conduct the professional consultation and detection,which can increase the blood transfusion safety coefficient and also prevents the spread of HIV/AIDS.Aiming at the false positive blood donors,the works of follow up,tracking monitoring and return to the blood donation team should be done well for reducing the run away of blood donors.Selecting more sensitive reagents and more sensitive method for the amplification of virus nucleic acid can shorten the infection risk of the window period as far as possible for ensuring the safety of blood transfusion.