豫东地区无偿献血人群HIV感染状况分析及防控策略探讨

HIV seroprevalence in voluntary blood donors in eastern Henan area, China

目的了解豫东地区无偿献血人群人类免疫缺陷病毒(HIV)的感染状况,为无偿献血招募及确保临床用血安全提供依据。方法采用ELISA法和NAT法对2013年1月—2018年12月960 792例无偿献血者血液标本进行HIV筛查,初筛反应性标本送当地HIV确证实验室确证,并对HIV阳性者不同人群分布特征进行分析。结果 960 792例无偿献血者确证HIV阳性188例,阳性率为1.96/万,不同年份HIV阳性率比较差异无统计学意义(P<0.05);男性献血者阳性率(2.69/万)高于女性(0.82/万),初次献血阳性率(4.97/万)高于多次献血(0.77/万),全血阳性率(2.11/万)高于单采血小板(0.36/万),差异均有统计学意义(P<0.05);不同文化程度、职业组间比较差异有统计学意义(P<0.05);随献血者年龄增长,HIV阳性率呈下降趋势,不同年龄段HIV阳性率比较差异有统计学意义(P<0.05);男性HIV阳性率呈逐年升高趋势,但不同年度比较差异无统计学意义(P>0.05);188例阳性献血者中,单纯HIV阳性148例(78.72%),合并其他感染40例(21.28%)。结论豫东地区无偿献血人群HIV感染率呈逐年上升趋势,感染者主要为40岁以下男性和初次献血人群,全血HIV阳性率高于单采血小板,做好献血前健康征询,从低危人群中招募献血者,以确保血液质量。

Objective To study HIV seroprevalence in voluntary blood donors in eastern Henan area, so as to provide references for blood donor recruitment and safeguard blood safety. Methods A total of 960 792 donations from January 2013 to December 2018 were screened for HIV by ELISA and NAT. All initially reactive donations were confirmed by HIV confirmatory laboratory and the sociodemographic profile of HIV-positive donors in different populations were analyzed. Results 188 HIV-positive donations were confirmed out of 960 792 blood samples, with an overall seroprevalence of 1.96/10 000, and no significant difference in seroprevalences among different years was observed(P<0.05). Male donors(2.69/10 000), first-time donors(4.97/10 000) and whole blood donors(2.11/10000) had a significantly higher HIV seroprevalence than female donors(0.82/10 000), repeat donors(0.77/10 000) and apheresis platelet donors(0.36/10 000), respectively(P<0.05). HIV seroprevalences among populations with different cultural levels and occupations were statistically significant(P<0.05). A significant reduction in seroprevalence along the ageing of donors had been seen and HIV seropositivity among age groups had significant differences(P<0.05). The numbers of seropositive men was declining these years and this trend was in no association of year(P>0.05). In 188 donors, co-infection with other viruses were noted in 40 cases, and only HIV infection in 148 cases(78.72%). Conclusion The temporal trends in HIV seroprevalence of eastern Henan blood donors go upwards over recent 6 years. The majority of HIV seropositive population are males younger than 40 years old and first-time donors. Whole blood donors had a significant higher seroprevalence than that in platelet apheresis donors. More efforts should be intensified to health consultation before blood donation and encourage donations from individuals at low risk for HIV.