大连地区无偿献血人群HIV感染情况及防控策略分析

Analysis of HIV infection among blood donors in Dalian and prevention and control strategies

目的回顾性分析大连地区2014—2019年无偿献血人群HIV感染的现状和特点,为制定更好的防控措施和血液招募策略提供依据,进一步保证临床用血安全。方法对2014—2019年间大连市血液中心确认的HIV感染献血者流行病情况进行分析。HIV抗体筛查反应阳性样本按大连市CDC要求送检,采用Western Blot方法进行HIV抗体确认。CDC以送检样本和重新采样的结果均为阳性,签发HIV确认阳性报告。对于未能重新采样的献血者,本研究以HIV抗体或HIV抗体/抗原检测与HIV RNA同时反应性作为HIV感染的确认条件。结果2014—2019年间共完成无偿献血者血液筛查511463份,确认阳性141例,确认阳性率为27.57/10万。男性HIV确认阳性率为28.68/10万,明显高于女性的0.71/10万(P<0.001)。18~30岁人群HIV确认阳性率高于其他年龄组(P<0.001);初次献血者确认阳性率(19.75/10万)高于重复献血者(9.64/10万)(P<0.001)。141例HIV确认阳性者中,男137例,占97.16%;18~30岁献血者101例,占71.63%;未婚105例,占74.47%;首次献血96例,占68.09%;街头固定采血点113例,占80.14%。结论2015年以来,本中心无偿献血者HIV确认阳性数和HIV感染率逐年递减,其中以男性、低龄、未婚、初次献血者感染率较高,经输血传播HIV风险仍不容忽视,需进一步采取更为有效的措施,制定具有针对性的招募和咨询策略。

Objective To retrospectively analyze the status and characteristics of HIV infection among blood donors in Dalian from 2014 to 2019,so as to provide basis for formulating better prevention and control measures and blood recruitment strategies,and further ensure the safety of clinical blood use.Methods The epidemic situation of HIV infected blood donors confirmed by Dalian Blood Center from 2014 to 2019 was analyzed.HIV antibody screening positive samples were submitted for tests according to the requirements of Dalian CDC,and the HIV antibody was confirmed by Western Blot.CDC issued HIV positive report based on the positive results of samples and resampling.For blood donors who failed to resample,HIV antibody or HIV antibody/antigen detection and HIV RNA co-reactivity were used as confirmation conditions for HIV infection.Results From2014 to 2019,511463 blood donorswere screened,ofwhom141 caseswere confirmed positive,with the positive rate of 27.57/100000.The HIV positive rate of male was 28.68/100000,which was significantly higher than that of female(0.71/100000)(P<0.001);the HIV positive rate of 18-30 years old group was higher than that of other age groups(P<0.001);the HIV positive rate of first-time blood donors(19.75/100000)was higher than that of repeated blood donors(9.64/100000)(P<0.001).Among 141 HIV positive cases, the proportion of male was 97.16% (137 cases), the proportion of18-30 years old was 71.63% (101 cases), the proportion of spinsterhood was 74.47% (105 cases),the proportion of first-time blood donors was 68.09% (96 cases), the proportion of samples fromfixed blood collection points on the street was 80.14% (113 cases). Conclusions Since 2015, thenumber of confirmed HIV positive blood donors and HIV infection rate have been decreasing year byyear. Among them, male, young, unmarried, and first-time blood donors have higher infection rates.The risk of HIV transmission through blood transfusion should not be ignored. More effectivemeasures should be taken to formulate targeted recruitment and consultation strategies.