南京地区无偿献血人群HBV感染情况调查

Investigation of HBV infection among eligible volunteer blood donors in Nanjing City

目的了解南京地区无偿献血者HBV感染人群分布情况,分析HBV在不同性别、年龄、城乡差异等方面的感染情况。方法选取南京红十字血液中心2015年01月-2016年01月期间金标乙肝试纸快检合格后的无偿献血者的血液标本66 742份,分别行ELISA和NAT筛查实验,对无偿献血者进行年龄、性别、教育程度、民族、婚姻状况、区域、献血情况与HBV筛查阳性结果分析。结果本研究66 742例无偿献血者中,HBV筛查总阳性225例(0.34%),ELISA阳性180例(0.27%),NAT阳性45例(0.07%);无偿献血者HBV阳性率与年龄段、性别,教育程度和婚姻状况无关(P>0.05);而不同地区无偿献血者在HBV阳性检出率,城市明显高于农村(χ~2=4.496,P<0.05);汉族与其他民族相比,无偿献血者HBV阳性率较高,且差别有统计学意义(χ~2=4.523,P<0.05)。结论南京地区无偿献血者HBV阳性率仍有一定比例,使用NAT方法可以大大缩短"窗口期",显著降低因ELISA漏检而导致的输血后乙肝病毒感染发生率,需大力普及ELISA+NAT的应用,进一步降低输血过程中乙肝病毒的传播风险。

Objective To understand the distribution and demographic characteristics of HBV （hepatitis B virus） in- fection among blood donors in Nanjing City. Methods Rapid testing, ELISA and the nucleic acid technology （NAT） screening were used to detect HBV infection among 66 742 blood samples collected from Nanjing Red Cross blood center from January 2015 to January 2016. Analysis was conducted on age, gender, education, nationality, marital status, region, blood donation and positive results of HBV screening. Results In this study, among 66 742 cases of volunteer blood donors, a to- tal of 225 cases （0. 34%） were HBV screening positive, 180 （0. 27%） were ELISA positive, 45 （0. 07%） were NAT posi- tive. There were no effects of age, gender, education and marital status on the incidence of HBV infection （P〉0. 05）. The infection rate in urban donors was statistically higher than those in rural donors （X2 = 4. 496, P.gO. 05） and also Han donors also had higher HBV infection risk than donors of other ethnic groups （X2 = 4. 523, P〈0. 05）. Conclusion The positive rate of blood donors in Nanjing HBV still occupies a certain proportion. The use of NAT method can greatly shorten the window period. It can significantly decrease the rates of failure of ELISA detection on post transfusion hepatitis B virus infection and also popularize ELISA＋ NAT application, in order to further reduce the transmissible risk of hepatitis B virus.