2020—2022年承德市无偿献血者中乙肝病毒感染情况及其影响因素分析

Status of hepatitis B virus infection and its influencing factors among unpaid blood donors in Chengde City,2020-2022

目的调查2020—2022年承德市无偿献血者中乙肝病毒感染情况,并分析其影响因素,为制定符合该地区献血招募指南,提高地区用血安全提供依据。方法选取2020—2022年承德市224560例无偿献血者作为调查对象,通过献血者健康征询表及血站的信息管理系统收集无偿献血者一般资料,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)及病毒核酸检测技术(nucleic acid amplification testing,NAT)检测乙肝病毒感染情况,运用单因素χ^(2)检验和多因素logistic回归分析评估影响2020—2022年承德市无偿献血者乙肝病毒感染的相关因素。结果2020—2022年承德市224560例无偿献血者共检出1050例乙肝病毒感染者,感染率为0.47%,其中2020—2022年每年乙肝病毒感染率分别为0.58%、0.47%、0.38%,呈逐年下降趋势,差异有统计学意义(χ^(2)=31.205,P<0.001)。单因素分析结果显示,不同输血史、不安全性行为、乙肝疫苗接种史、乙肝家族病史、侵入性诊疗史的无偿献血者其乙肝病毒感染发生率比较差异均有统计学意义(P<0.001)。多因素logistic分析显示,有输血史(OR=3.047,95%CI:1.848~5.022)、有不安全性行为(OR=3.222,95%CI:1.839~5.644)、无乙肝疫苗接种史(OR=3.404,95%CI:1.909~6.069)、有乙肝家族病史(OR=2.344,95%CI:1.622~3.389)、有侵入性诊疗史(OR=2.617,95%CI:1.720~3.981)均是影响2020—2022年承德市无偿献血者乙肝病毒感染的危险因素(P<0.05)。结论2020—2022年承德市无偿献血者中乙肝病毒感染率较高,并与输血史、不安全性行为、乙肝疫苗接种史、乙肝家族病史、侵入性诊疗史等多种因素相关。因此,要重视无偿献血者中乙肝病毒感染情况,进一步强化危险因素筛查,同时制定符合该地区的献血招募指南,降低其乙肝病毒感染风险。

Objective To investigate the status of hepatitis B virus infection amongst unpaid blood donors in Chengde City from 2020 to 2022,to analyze its influencing factors,and to provide a basis for formulating blood donation recruitment guidelines in line with the local area and improving the safety of regional clinical blood use.Methods A total of 224,560 voluntary blood donors in Chengde City from 2020 to 2022 were selected as the surveyed subjects.The voluntary blood donors’general information was collected through the blood donor health inquiry form and the information management system of the blood station.Enzyme-linked immunosorbent assay(ELISA)and nucleic acid amplification testing(NAT)were used to detect hepatitis B virus infection.Univariateχ^(2) test and multivariate logistic regression analysis were employed to evaluate the related factors of hepatitis B virus infection among the voluntary blood donors in Chengde City from 2020 to 2022.Results A total of 1,050 patients with hepatitis B virus infection were detected among the 224,560 voluntary blood donors in Chengde City from 2020 to 2022,with the infection rate of 0.47%.The annual infection rate of hepatitis B virus in 2020,2021 and 2022 was 0.58%,0.47%and 0.38%respectively,showing a downward trend year by year,and the differences were statistically significant(χ^(2)=31.205,P<0.001).The results of univariate analysis displayed that there were statistically significant differences in the incidence rate of hepatitis B virus infection among voluntary blood donors with or without blood transfusion history,unsafe sex,hepatitis B vaccination history,family history of hepatitis B,and history of invasive diagnosis and treatment(all P<0.001).Multivariate logistic regression analysis revealed that having a history of blood transfusion(OR=3.047,95%CI:1.848-5.022),having a history of unsafe sex(OR=3.222,95%CI:1.839-5.644),having no history of hepatitis B vaccination(OR=3.404,95%CI:1.909-6.069),having a family history of hepatitis B(OR=2.344,95%CI:1.622-3.389)and having a history of invasive diagnosis and treatment(OR=2.617,95%CI:1.720-3.981)were risk factors for hepatitis B virus infection in the voluntary blood donors in Chengde City from 2020 to 2022(all P<0.05).Conclusion The infection rate of hepatitis B virus among the voluntary blood donors in Chengde City during 2020-2022 was high and related to many factors such as blood transfusion history,unsafe sex,hepatitis B vaccination history,family history of hepatitis B and history of invasive diagnosis and treatment.Therefore,it is necessary to pay special attention to hepatitis B virus infection in the voluntary blood donors,further strengthen the screening of risk factors,and simultaneously formulate blood donation recruitment guidelines in line with the local area so as to reduce the risk of hepatitis B virus infection.