2015-2019年云南省献血者血清阳性隐匿性乙肝病毒感染流行病学特征

Epidemiological characteristics of seropositive occult hepatitis B virus infection among blood donors in Yunnan province from 2015 to 2019

目的统计分析2015-2019年云南省献血者血清阳性隐匿性乙肝病毒感染(OBI)的流行病学特征,为招募献血对象的选择和乙肝防治提供更多依据。方法以酶联免疫吸附法(ELISA)及核酸扩增技术(NAT)对2015-2019年云南省的85384例献血者进行乙型肝炎病毒(HBV)感染标志物检测,再结合一般流行病学统计资料(献血者年龄、性别、学历、献血次数)分析血清阳性OBI的检出情况。结果85384例献血标本进行HBV核酸检测,共有111例HBV DNA阳性,进一步检测乙肝两对半显示,共有100例为抗-HBc(+)和/或抗HBe(+)、抗HBs(+),诊断为血清阳性OBI,血清阳性OBI感染率为0.12%(100/85384)。高学历组阳性率为0.07%,明显低于低学历组0.14%,差异有统计学意义(P<0.05);3650岁年龄组阳性率为0.14%,较1835岁年龄组献血者0.10%明显升高,差异有统计学意义(P<0.05)。男性献血者血清阳性OBI阳性率为0.15%,较女性0.07%明显升高(P<0.05)。不同献血次数组间差异无统计学意义(P>0.05)。不同职业组间阳性率比较差异有统计学意义(P<0.05)。以年龄、性别、职业学历为自变量,多因素Logistic回归分析显示,>36岁、大专以下学历、男性、农民工及工人为血清阳性OBI的独立危险因素(P<0.05)。结论核酸检测有利于提高OBI感染检出率,其中男性、低学历、高年龄、农民工及工人是血清阳性OBI的独立危险因素。

Objective To analyze the epidemiological characteristics of seropositive occult hepatitis B virus infection(OBI)among blood donors in Yunnan province from 2015 to 2019,and provide more basis for the selection of blood donors and prevention and treatment of hepatitis B.Methods Hepatitis B virus(HBV)infection markers of 85384 blood donors in Yunnan province from 2015 to 2019 were detected by enzyme linked immunosorbent assay(ELISA)and nucleic acid amplification technology(NAT),and then combined with the general epidemiological data(blood donor age,gender,education,blood donation times)to detect and analyze seropositive OBI.Results In this study,85384 blood donation specimens were detected for nucleic acid,and 111 cases were positive for HBV-DNA;of which,100 cases were anti-HBc(+)and/or anti HBe(+),anti HBs(+);they were diagnosed as positive serum OBI,with infection rate of 0.12%(100/85384).The positive rate of higher education group was 0.07%,which was significantly lower than that of lower education group(0.14%)(P<0.05);the positive rate in 36-50 years old group was 0.14%,which was significantly higher than 0.10%in 18-35 years old group(P<0.05),and the positive rate of positive serum OBI in male blood donors was 0.15%,which was significantly higher than 0.07%in female donors(P<0.05);there was no significant difference among different blood donation times(P>0.05);the positive rate among different occupational groups was statistically significant(P<0.05).Multivariate Logistic regression analysis was conducted with age,gender,occupation and educational background as independent variables,and the results showed that over 36 years old,with lower education background,male,migrant workers and workers were the independent risk factors of positive serum OBI(P<0.05).Conclusion Nucleic acid test was helpful to improve the detection rate of OBI infection;among which,male,lower education level,old age,migrant workers and workers were independent risk factors of seropositive OBI.