保定地区无偿献血患者核酸检测HBV感染现状及影响因素分析

Current situation and influence factors on the nucleic acid detection of HBV infection in voluntary unpaid donors in Baoding area

目的调查保定地区无偿献血患者核酸检测HBV感染现状,并分析其影响因素。方法选取2019年1月至2020年12月保定市中心血站HBsAg快筛合格标本207000份,均行经酶联免疫法(ELISA)、病毒核酸检测技术(NAT)检测。比较不同时间、不同人群特征HBsAg筛查阴性献血者HBV感染情况,分析HBsAg筛查阴性献血者HBV DNA阳性的影响因素。结果HBsAg快筛合格标本207000份,经ELISA检测HBsAg阳性949份,HBsAg筛查阴性献血者HBV DNA阳性率为0.050%(103/206051);103例HBsAg(-)/HBV DNA(+)献血者HBV DNA定量检测结果显示,以低病毒载量为主,血清学模式以抗-HBs(+)/抗-HBe(-)/抗-HBc(-)为主。不同时间HBsAg筛查阴性献血者整体、男性、女性HBV DNA阳性率均差异无统计学意义(P>0.05);有静脉吸毒史、不安全性行为、输血史的HBsAg筛查阴性献血者HBV DNA阳性率高于无静脉吸毒史、不安全性行为、输血史者(P<0.05);logistic回归分析发现,静脉吸毒史、不安全性行为、输血史是HBV阳性的影响因素(P<0.05)。结论无偿献血者存在一定HBV阳性风险,以低病毒载量为主,在常规ELISA筛查基础上应进一步强化危险因素筛查,以降低HBV传播风险。

Objective To investigate the current situation on the nucleic acid detection of hepatitis B virus(HBV)infection in voluntory unpaid blood donors in Baoding area,and to analyze the influencing factors.Methods A total of 207,000 donors with hepatitis B surface antigen(HBsAg)rapid test in our blood center from January 2019 to December 2020 were enrolled.Enzyme-linked immunoassay(ELISA)and viral nucleic acid detection technology(NAT)were performed in all cases.The clinical characteristics and influence factors of HBsAg-negative blood donors with HBV infection were compared and analyzed.Results The ELISA results of 207000 qualified samples showed that HBsAg positive in 949 cases,and the HBV DNA positive rate of HBsAg-negative cases was 0.050%(103/206051).The result of HBV DNA quantitative test in 103 HBsAg(-)/HBV DNA(+)blood donors showed that low viral load was the main reason,and the main serological model was hepatitis B surface antibody(anti-HBs)(+)/hepatitis B e antibody(antibody-HBe)(-)/hepatitis B core antibody(anti-HBc)(-).There was no significant difference in HBV infection rate among all blood donors with negative HBsAg screening at different times(P>0.05).There was also no significant difference in HBV infection rate between male and female(P>0.05).The HBV positive rate of blood donors with a history of intravenous drug use,unsafe sex,and blood transfusion was higher than those without the above-mentioned situation.(P<0.05);Logistic regression model analysis showed that the history of intravenous drug use,unsafe sex,and history of blood transfusion were influencing factors of HBV infection(P<0.05).Conclusion There is a certain rate of voluntary blood donors with HBV infection,and most of carriers with low viral load.Screening of risk factor should be further strengthened on the basis of ELISA screening to reduce the risk of HBV transmission.