无锡地区HBsAg(-)/HBV-DNA(+)的无偿献血者流行病学特征分析

Epidemiologic analysis of HBsAg(-)/HBV DNA(+)volunteer blood donors in Wuxi regions

目的了解无锡地区(无锡市、江阴市和宜兴市)乙型肝炎病毒表面抗原(HBsAg)(-)/乙型肝炎(HBV)DNA(+)无偿献血者的一般流行病学特征,根据不同地区HBsAg(-)/HBV-DNA(+)献血者的特征制定献血者HBV筛查策略,提高献血筛查力度,降低输血传播HBV的风险。方法采用酶联免疫吸附实验(ELISA)和核酸扩增技术(NAT)检测的方法,检测无锡地区无偿献血者HBsAg(-)/HBV-DNA(+)的不合格人数。统计HBsAg(-)/HBV-DNA(+)无偿献血者的HBV-Ct值、年龄、性别、户籍、学历、婚姻状况和献血次数的差异。结果2015-2018年共检测出的322例HBsAg(-)/HBV-DNA(+)的无偿献血者,总体不合格率由0.13%下降至0.07%(P=0.003),呈逐年下降的趋势。3市均以大于40岁以上人群居多,但是宜兴市大于40岁以上人群明显高于其他两市,差异有统计学意义(P=0.002);无锡市以外的户籍居多,而江阴和宜兴市以本地户籍居多(P<0.001);无锡市的未婚人群相比江阴和宜兴市较多(P<0.001);无锡市的HBsAg(-)/HBV-DNA(+)献血者以首次献血居多,而江阴和宜兴市以2次及以上献血者居多(P=0.005)。结论3市HBsAg(-)/HBV-DNA(+)的无偿献血者具有不同的流行病学特征,应结合不同地区HBsAg(-)/HBV-DNA(+)献血者的不同特征制定HBV筛查策略,降低输血传播风险,保证血液安全。

Objective To investigate the epidemiological features among HBsAg(-)/HBV DNA(+)volunteer blood donors in Wuxi regions(Wuxi,Jiangyin and Yixing city).According to the characteristics of HBsAg(-)/HBV DNA(+)donors in different regions,the strategy of HBV screening for blood donors was formulated to improve the intensity of blood donation screening and reduce the risk of blood transfusion transmission of HBV.Methods The number of unqualified HBsAg(-)/HBV-DNA(+)donors in Wuxi area was detected by enzyme-linked immunosorbent assay(ELISA)and nucleic acid amplification(NAT).The difference of HBV CT value,age,sex,household registration,education background,marital status and times of blood donation of HBsAg(-)/HBV DNA(+)free blood donors were statistically analyzed.Results From 2015 to 2018,322 cases of HBsAg(-)/HBV DNA positive blood donors were detected.The overall unqualified rate decreased from 0.13%to 0.07%(P=0.003),showing a downward trend year by year.The unqualified rate mainly focus in the people aged more than 40 years old in those three city,but there was a significant difference(P=0.002)between Yixing and the other two cities.Non local household registration in Wuxi had higher unqualified rate,while local household registration in Jiangyin and Yixing had higher unqualified rate(P<0.001).Unmarried people in Wuxi had higher unqualified rate than that in Jiangyin and Yixing(P<0.001).First time blood donor had higher unqualified rate in Wuxi,while in Jiangyin and Yixing,the second time blood donor had higher unqualified rate(P=0.005).Conclusion HBsAg(-)/HBV DNA(+)volunteer blood donors in the three cities had different epidemiological features.This study suggested that controlling measures should be made according to these features to guarantee the safe of clinical blood use and reduce the risk of HBV infection in blood transfusion.