2016至2020年杭州地区无偿献血人群HIV感染状况分析

Analysis on HIV infection status of unpaid blood donors in Hangzhou from 2016 to 2020

目的了解杭州地区无偿献血人群HIV感染状况,为本地区降低HIV经输血传播风险,制定有效献血者招募及艾滋病防控策略提供数据支持。方法采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)和病原体核酸检测技术(nucleic acid testing,NAT)对2016年1月至2020年12月杭州地区902847例无偿献血者标本进行抗HIV-Ⅰ/Ⅱ抗体/抗原和HIVRNA检测。抗-HIV抗体/抗原或HIVRNA反应性标本送杭州市疾病控制中心进一步采用Western blot法和NAT进行确认。结果2016年1月至2020年12月杭州地区共检测HIV确证阳性103例,阳性检出率为0.01%,其中101例ELISA和NAT筛查均为阳性反应,2例ELISA筛查为阴性反应,NAT为阳性反应。103例感染者中,以男性(91.26%,94/103)、18~35岁(69.90%,72/103)、初次献血者(68.93%,71/103)为主。2016至2020年献血者HIV阳性率呈逐年下降趋势(χ^(2)=7.181,P=0.007)。男女献血者HIV阳性率各年的差异无统计学意义(χ^(2)=10.336,P=0.350;χ^(2)=0.653,P=0.957)。各年龄组献血者HIV阳性率各年的差异无统计学意义(χ^(2)=6.378,P=0.173;χ^(2)=2.318,P=0.678;χ^(2)=5.284,P=0.259;χ^(2)=9.183,P=0.057)。结论近5年HIV感染在杭州市无偿献血人群中呈低流行水平,但仍存在感染风险,应加强在低危人群中招募献血者并且应采用先进的检测技术,选择合适的检测策略,保证血液安全。

Objective To understand the status of HIV infection among unpaid blood donors in Hangzhou,and to provide data support for reducing the risk of HIV transmission through blood transfusion,and formulating effective blood donor recruitment and AIDS prevention and control strategies in Hangzhou.Methods Enzyme-linked immunosorbent assay(ELISA)and nucleic acid testing(NAT)were used to detect HIV-Ⅰ/Ⅱantibody/antigen and HIV RNA from 902847 unpaid blood donors in Hangzhou from January 2016 to December 2020.Anti-HIV antibody/antigen or HIV RNA reactive samples were sent to Hangzhou Center for Disease Control(CDC)for further confirmation by Western bloting and NAT.Results A total of 103 HIV positive cases were detected in Hangzhou area from January 2016 to December 2020,with a positive detection rate of 0.01%,101 cases were positive for ELISA and NAT screening,2 cases were negative for ELISA screening and positive for NAT.Among the 103 infected patients,males(91.26%,94/103),18-35 years old(69.90%,72/103),and first-time blood donors(68.93%,71/103)were the majority.The positive rate of HIV among blood donors decreased year by year from 2016 to 2020(χ^(2)=7.181,P=0.007),but there was no significant difference in HIV positive rate between male and female blood donors(χ^(2)=10.336,P=0.350;χ^(2)=0.653,P=0.957).There was no significant difference in HIV positive rate among blood donors of different age groups(χ^(2)=6.378,P=0.173;χ^(2)=2.318,P=0.678;χ^(2)=5.284,P=0.259;χ^(2)=9.183,P=0.057).Conclusion In recent 5 years,HIV infection has been at a low epidemic level among unpaid blood donors in Hangzhou,but there is still an infection risk.It is necessary to strengthen the recruitment of blood donors from low-risk groups,adopt advanced detection technology and select appropriate detection strategies to ensure blood safety.