浙江沿海地区无偿献血人群HTLV感染的流行病学与知晓情况调查

Epidemiological study on the human T-cell leukemia virus type Ⅰ/Ⅱ infection in the east coastal areas of Zhejiang province

目的了解浙江沿海地区无偿献血者人类嗜T淋巴细胞病毒(HTLV)感染状况,提出综合性防控策略。方法采用ELISA方法筛查2013-2015年浙江省沿海6市(区)无偿献血者58 609(人)份血清中抗-HTLV-Ⅰ/Ⅱ,阳性者以WB法确证,并做HTLV基因测序和同源性分析;随机对10 197名献血者开展HTLV知晓情况问卷调查。结果本组献血者人群的抗-HTLV阳性率0.01%(5/58 609),抗体类型为抗-HTLV-Ⅰ,均属世界群世界人种亚型;该5位HTLV感染者均为本地首次献血者,其中台州市发现的HTLV毒株与福建泉州的分离株同源,舟山市发现的HTLV毒株与日本的分离株MT-2同源。献血者对HTLV的知晓情况:随机问卷调查(10分制)人均得分0.75(0-8)分,其中<1分者占调查对象的79.0%(8059/10 197),>5分者占1.40%(143/10 197)。结论浙江沿海台州和舟山地区献血人群中存在HTLV感染和散在的小流行;献血者对HTLV的知识极其匮乏,亟待采取相应防控策略。

Objective To study the prevalence of HTLV- Ⅰ / Ⅱ in volunteer blood donors in the east coastal areas of Zhejiang province and to provide comprehensive preventive measures. Methods HTLV- Ⅰ / Ⅱ antibody was detected by ELISA in voluntary blood donors from 2013 to 2015 in the east coastal areas of Zhejiang province. The positive samples were confirmed by WB, PCR and homology analysis. A survey of knowledge about HTLV infection was performed. Results The positive rate for HTLV antibody was 0. 01% （5/58 609） , and the prevalent antibody was anti-HTLV- I ~ Homology analysis showed that HTLV- I belonged to the subtype of Mongoloid race. The five donors were first-time local donors. The HTLV strains found in Taizhou were homologous strains of Quanzhou of Fujian province, while the HTLV strains found in Zhoushan were homologous strains of Japan. The mean score of knowledge on HTLV infection among blood donors was only 0. 75 （ 0- 8）. About 79.0% （8 059/10 197） of the respondents received the scores of one or lower and only about 1.40% （ 143/10 197） of the respondents received the scores of five or higher. Conclusion It is suggested that in the east coastal areas of Zhejiang province, HTLV- I was the main prevalent virus. The prevalence of HTLV- I was very low without HTLV-lI. There was a severe lack of knowledge about HTLV infection and a critical need to take comprehensive preventive measures.