杭州市无偿献血者乙型肝炎病毒感染及其传播残余风险分析

Prevalence of hepatitis B virus infection and residual transmission risk among volunteer blood donors in Hangzhou City

目的了解杭州市无偿献血者乙型肝炎病毒(HBV)感染情况,评估输注其血液传播HBV的残余风险。方法通过献血者信息管理数据库收集2016—2019年杭州市无偿献血者资料,采用酶联免疫吸附法测定乙型肝炎表面抗原(HBsAg)和核酸检测技术测定HBV DNA。采用发病率-窗口期模型评估无偿献血者血液传播HBV的残余风险。结果2016—2019年杭州市共筛查初次献血者320755人,HBV阳性率为0.56%;重复献血者279816人,HBV阳性率为0.13%。初次献血者HBV阳性率高于重复献血者(P<0.05)。初次献血者和重复献血者检测HBsAg后,输血传播HBV的残余风险分别为296.38/100万人次[95%CI:(277.57~315.19)/100万人次]和98.79/100万人次[95%CI:(87.15~110.43)/100万人次];检测HBV DNA后,输血传播HBV的残余风险分别为86.79/100万人次[95%CI:(76.60~96.98)/100万人次]和28.93/100万人次[95%CI:(22.63~35.23)/100万人次]。结论经检验合格的杭州市无偿献血者血液仍然存在输血传播HBV的风险,献血人群中开展核酸检测可明显降低输血传播HBV的残余风险。

Objective To investigate the prevalence of hepatitis B virus(HBV)infection among volunteer blood donors in Hangzhou City,and to evaluate the residual risk of transfusion-transmitted HBV infections.Methods Data pertaining to volunteer blood donors in Hangzhou City from 2016 to 2019 were retrieved from the blood donor management system.Hepatitis B surface antigen(HBsAg)was detected by enzyme-linked immunosorbent assay(ELISA)and HBV DNA was detected using nucleic acid testing.The incidence/window period model was employed to assess the residual risk of HBV transmitted through transfusion from donors.Results The prevalence of HBV infections was 0.56% among the 320755 first-time donors and 0.13% among the 279816 repeat donors in Hangzhou City from 2016 to 2019,and a higher prevalence of HBV infection was detected among first-time donors than among repeat donors(P<0.05).The residual risks of transfusion-transmitted HBV infection were 296.38 per million person-times(95%CI:277.57 to 315.19 per million person-times)and 98.79 per million person-times(95%CI:87.15 to 110.43 per million person-times)among first-time and repeat donors with positive HBsAg,and were 86.79 per million person-times(95%CI:76.60 to 96.98 per million person-times)and 28.93 per million person-times(95%CI:22.63 to 35.23 per million person-times)among first-time and repeat donors tested positive for HBV DNA,respectively.Conclusions There is still a residual risk of HBV infection transmitted through transfusion from blood donors in Hangzhou City.Nucleic acid testing may remarkably reduce the residual risk of transfusion-transmitted HBV infection in blood donors.