重庆市单采血小板献血者经血传播HIV的残余风险评估

Estimating the residual risk for HIV in apheresis platelet donors in Chongqing

目的了解重庆地区初次、重复单采血小板献血者人类免疫缺陷病毒(HIV)的感染情况,评估血液常规筛查后仍存在的经血传播HIV的危险度,为现有血小板献血招募及血液筛查策略提供数据支持。方法收集2016-2020年重庆地区单采血小板献血者HIV项目的初筛和确证试验结果,分别计算重复献血者和初次献血者的HIV阳性率,并用发病率-窗口期模型进行经血传播HIV的残余风险评估。结果单采血小板献血者中,初次献血者HIV确认阳性14例,阳性率为0.155%,重复献血者确认阳性16例,阳性率为0.027%,二者间HIV确认阳性率比较,差异有统计学意义(χ^(2)=29.523,P<0.05)。对不同人口学特征的初次单采血小板献血者及重复单采血小板献血者的HIV阳性率分别进行比较,结果显示:不同年龄分组的献血者HIV阳性率比较,差异均无统计学意义(χ^(2)=3.736、1.357,P>0.05);不同性别献血者HIV阳性率比较,差异均有统计学意义(χ^(2)=5.452、4.986,P<0.05);不同学历献血者HIV阳性率比较,差异均有统计学意义(χ^(2)=18.863、12.049,P<0.05)。重复单采血小板献血者经血传播HIV的残余风险为1/275851。结论重庆地区单采血小板献血者中HIV残余风险处于较高水平,主要来源于初次献血、低学历、男性人群;加强初次献血者的前端征询、筛查,以及定期对献血者进行健康知识科普,优化固定志愿献血者队伍,可进一步降低重庆地区经血小板输注传播HIV的风险。

Objective To understand the infection rate of human immunodeficiency virus(HIV)in the first and repeated apheresis platelet donors in Chongqing,assess the risk of HIV transmission after routine blood screening,provide data support for existing blood donation recruitment and blood screening strategies.Methods Collect the preliminary screening and confirmatory experimental results of HIV project of apheresis platelet donors in Chongqing from 2016 to 2020,calculate the HIV prevalence of repeat blood donors and initial blood donors respectively,and use the prevalence window model to assess the residual risk of transfusion-transmitted HIV infections.Results Among apheresis platelet donors,the number of first blood donors and repeated blood donors were 14 and 16 cases respectively,the positive rate of HIV was 0.155%in the first blood donors and 0.027%in the repeated blood donors,the difference of HIV positive rate between the two groups was statistically significant(χ^(2)=29.523,P<0.05).There was no significant difference in HIV positive rate between different age groups(χ^(2)=3.736,1.357,P>0.05).There were statistically significant differences in HIV positive rate between different gender donors(χ^(2)=5.452,4.986,P<0.05).There were statistically significant differences in HIV positive rate between blood donors with different education levels(χ^(2)=18.863,12.049,P<0.05).The residual risk of HIV transmission through blood among repeat apheresis platelet donors was 1/275851.Conclusion The prevalence of HIV in apheresis platelets with repeated platelets in Chongqing is at a relatively high level,mainly from first-time,low educated,and male populations.Strengthening the front-end consultation and screening of first-time donors,as well as regular health education for blood donors and optimizing the team of fixed volunteer donors can further reduce the risk of platelet transfusion transmission of HIV in Chongqing.