2010～2015年广州地区无偿献血人群HIV感染现状分析

Analysis on the Status of HIV Infection of Voluntary Non-remunerated Blood Donors in Guangzhou Area,2010～2015

目的回顾性分析广州地区2010～2015年无偿献血人群HIV感染现状和特点,为制定充足、安全的血液招募和保障策略提供依据。方法采用ELISA和NAT法对1 553 378份无偿献血者标本进行HIV筛查,二者均为阳性的标本送CDC确认,经确认试验为阳性者即为HIV阳性,对此部分献血者进行流行病学资料分析。结果 1 553 378份标本中,共检出460例阳性标本,总阳性率为29.6/10万。感染数及感染率呈逐年递增趋势。男性感染率(42.0/10万)远高于女性感染率(5.2/10万)。不同年龄组阳性率由高到低依次为26～35岁、18～25岁、36～45岁、46～60岁,差异有统计学意义。HIV合并其他感染者共有103例,占比22.4%,其中以合并梅毒、丙肝、乙肝为主。初次献血人群阳性率32.9/10万高于再次献血阳性率24.6/10万;且再次献血人群中HIV感染率呈递增趋势。个体献血人群感染率49.0/10万高于团体献血人群感染率8.6/10万。全血献血人群感染率31.2/10万高于成分献血人群感染率3.4/10万。结论广州地区无偿献血人群中,HIV感染率呈逐年上升趋势,且低龄化趋势明显,以男性、个体、初次及全血献血者感染率较高。为降低经输血传播HIV的风险,应针对不同献血者群体制定有针对性的献血招募策略。

Objective To investigate the current status and characteristics of HIV infection among voluntary nonremunerated blood donors in Guangzhou from 2010 to 2015 and to provide evidence for new strategies which will ensure the adequacy and safety of blood recruitment.Methods A total of 1 553 378 blood specimens of voluntary non-remunerated blood donors were screened for HIV by ELISA and NAT. All the specimens which were positive in the two testing were sent to CDC for confirmation test. The epidemiological features of voluntary non-remunerated blood donors with HIV positive were collected and analyzed.Results 460 donors were confirmed with HIV positive among the 1 553 378 blood specimens,with a positive rate of 29.6/100 000. Not only the number of the infected donors but also the positive rate of infection was increasing year by year. The HIV positive rate of male（42.0/100 000） is much higher than that of female（5.2/100 000）. HIV positive rates among different age groups were statistically different. The positive rate in different age groups ranged from high to low was 26-35 years old group,18-25 years old group,36-45 years old group,and 46-60 years old group. A total of 103 cases of HIV infection combined with other items,accounting for 22.4%,of which syphilis,hepatitis C and hepatitis B dominated. The HIV positive rate of first-time donors（32.9/100 000） is higher than that of repeated donors（ 24.6/100 000）,and the HIV positive rate of repeated donors is increasing. The HIV positive rate of individual donors（49.0/100 000）is significantly higher than that of group donors（8.6/100 000）.The HIV positive rate of whole blood donors（31.2/100 000）is clearly higher than that of component blood donors（3.4/100 000）.Conclusions In Guangzhou,the rate of HIV infection is increasing year by year,and the lowering trend of HIV infection age is obviously shown. And male,individual,first-time and whole blood donors have a significantly higher infection rate. To further reduce the risk of HIV transmission through blood transfusion,targeted blood donation and recruitment strategies should be developed for different blood donors; meanwhile,screening for HIV and/or its co-infected items on-site may be effective.