重庆地区无偿献血者HBV筛查结果及其阳性人群特征分析

Hepatitis B screening of voluntary blood donors and characteristics of HBV positive population,Chongqing

目的了解重庆地区无偿献血者的乙型肝炎病毒(hepatitis B virus, HBV)的感染特征和流行现状,分析其流行病学特征,为有效选择低危献血者提供参考。方法回顾性分析2017年10月~2020年10月本中心314 442名无偿献血者的乙肝表面抗原(hepatitis B surface antigen, HBsAg)与病毒核酸(HBV DNA)检测结果,统计分析献血者HBV总阳性率、HBsAg+/HBV DNA-、HBsAg-/HBV DNA+和HBsAg+/HBV DNA+4种情况分别与性别、婚姻、年龄、学历、职业和是否重复献血(初次献血和重复献血)之间的关系。结果本研究314 442名无偿献血者中,HBV总阳性率为0.88%(2 764/314 442),HBsAg+/HBV DNA-阳性率0.28%(893/314 442),HBsAg-/HBV DNA+阳性率0.18%(567/314 442)、HBsAg+/HBV DNA+阳性率0.41%(1 304/314 442)。HBV总阳性率、HBsAg-/HBV DNA+和HBsAg+/HBV DNA+3种情况在不同性别、婚姻、年龄、学历、职业及是否重复献血(初次献血和重复献血)之间有差异:3种情况的阳性率均是男性高于女性,已婚高于未婚,学历越高,阳性率越低,农民、工人群体的阳性率最高,阳性率最低的职业依次为医务人员、学生、军人、公务员、教师,初次献血者均高于重复献血者,差异具有统计学意义(P<0.01);3种情况阳性率均在18~50岁内随年龄逐渐升高,总阳性率、HBsAg+/HBV DNA+以41~50岁最高,HBsAg-/HBV DNA+以51~60岁最高,差异具有统计学意义(P<0.01)。HBsAg+/HBV DNA-仅在是否重复献血(初次献血和重复献血)之间的差异具有统计学意义(P<0.01),在不同性别、婚姻、年龄、学历、职业之间的差异无统计学意义(P>0.05)。结论重庆地区无偿献血人群HBV疫情相对呈高流行态势,且性别、婚姻、年龄、学历、职业、是否重复献血均与重庆地区献血者HBV阳性率相关,因此,必须加强献血前对献血者的有效征询招募,编制符合本地区的献血招募指南,从低危人群中招募无偿献血者,提高血液安全质量。

Objective To explore the characteristics and prevalence of HBV infection among voluntary blood donors in Chongqing and analyze its epidemiological characteristics,so as to provide reference for effective selection of low-risk blood donors.Methods The test results of hepatitis B surface antigen(HBsAg)and viral nucleic acid(HBV DNA)of 314442 voluntary blood donors from October 2017 to October 2020 in Chongqing Blood Center were retrospectively analyzed.The relationship between the total positive rate of HBV,HBsAg+/HBV DNA-,HBsAg-/HBV DNA+,HBsAg+/HBV DNA+and gender,marriage,age,education background,occupation,firs-time blood donation and repeated blood donation was analyzed.Results Among the 314442 voluntary blood donors,the total positive rate of HBV,HBsAg+/HBV DNA-,HBsAg-/HBV DNA+and HBsAg+/HBV DNA+was 0.88%(2764/314442),0.28%(893/314442),0.18%(567/314442)and 0.41%(1304/314442),respectively.The total positive rate of HBV,HBsAg-/HBV DNA+and HBsAg+/HBV DNA+was different in gender,marriage,age,education background,occupation and firs-time/repeated blood donation.The positive rate of men was higher than that of women,and that of married higher than that of unmarried,and decreased as the education level elevated.The positive rate of farmers and workers was the highest and that of medical staff was the lowest,followed by students,military personnel,civil servants,and teachers.The positive rate of first-time blood donors was higher than that of repeated blood donors.The differences were statistically significant(P<0.05);The positive rate of HBV,HBsAg-/HBV DNA+and HBsAg+/HBV DNA+within 18~50 years old all increased gradually with age.the positive rate of HBsAg+/HBV DNA+was highest within 41~50 years old,and that of HBsAg-/HBV DNA+was highest within 51~60 years old,with statistical significance(P<0.05).The positive rate of HBsAg+/HBV DNA-was statistically significant between first-time and repeated blood donation(P<0.05),and there is no significant difference between gender,marriage,age,educational background,and occupation(P>0.05).Conclusion The prevalence of HBV among voluntary blood donors in Chongqing is relatively high and is related to gender,marriage,age,education background,occupation,and first-time/repeated blood donation.It is necessary to strengthen effective consultation before blood donation,formulate guidelines for blood donation recruitment,select voluntary blood donors from low-risk groups to improve blood safety.