2016-2022年湖州市无偿献血人群HIV-1新发感染特征研究

Characteristics of new HIV-1 infection among voluntary blood donors in Huzhou from 2016 to 2022

目的探讨2016-2022年湖州市无偿献血人群人类免疫缺陷病毒(HIV)-1新发感染特征情况。方法回顾性纳入2016年1月-2022年12月湖州市无偿献血人群血液标本233552份。经健康检查合格的献血者,献血时通过旁路留取EDTA-K2抗凝血液标本,采用酶联免疫吸附实验(ELISA法)分别进行HIV抗原/抗体的初检和复检,严格按照《全国艾滋病检测技术规范》(2015年修订版)中标准判定结果,将HIV-1抗体阳性的标本使用HIV-1新发感染酶免疫检测试剂盒,采用限制性抗原亲和力法检测标本是否为新发感染,若标本CD4细胞>200个/L且病毒载量>1000拷贝/mL则定义为新发感染。比较各年度的HIV-1抗体阳性情况,以HIV-1抗体阳性作为基数,采用卡方检验,比较HIV-1抗体阳性患者不同类型(性别、年龄、职业等)亚组HIV-1新发感染率。结果2016-2022年湖州市无偿献血人群血液标本233552份,其中HIV-1抗体阳性标本共15份,感染率为6.42/10万,其中新发感染和既往感染占比分别为40.00%和60.00%。2016-2022年,HIV-1感染率逐年下降(1.62%、1.24%、0.63%、0.31%、0.30%、0.28%和0.27%)。比较HIV-1抗体阳性15名患者不同类型(性别、年龄、职业等)亚组HIV-1新发感染率发现:重复献血亚组HIV-1新发感染率高于初次献血亚组,但组间比较统计学无差异(P>0.05);男性HIV-1新发感染率高于女性,但组间比较统计学无差异(P>0.05);在不同学历HIV-1抗体阳性献血者中,初中及以下新发感染占比较高,但与其他学历亚组人群比较无差异(P>0.05);不同职业亚组的HIV-1新发感染率比较也无统计学差异(P>0.05)。结论湖州地区近年来HIV-1新发感染率逐年下降,且新发感染的发生在初次献血与重复献血亚组及不同性别、学历、职业等亚组中无明显分布特征。

Objective To investigate the characteristics of HIV-1 infection among voluntary blood donors in Huzhou City from 2016 to 2022.Methods A total of 233552 voluntary blood donors in Huzhou,Zhejiang from January 2016 to December 2022 were retrospectively analyzed.Blood donors who were qualified for health examination were required to take EDTA-K2 anticoagulant blood samples by bypass during blood donation.Enzyme-linked immunosorbent assay(ELISA)was used for initial screening and re-examination of HIV antigen/antibody.The results were determined in strict accordance with the criteria in National AIDS Testing Technical Specification(2015 Revision).HIV-1 antibody-positive samples were detected by HIV-1 new infection enzyme immunoassay kit,and the restricted antigen affinity method was used to detect whether the samples were new infections.Samples with CD4 cells>200/L and the viral load>1000 copies/mL were defined as new infection.The positive rate of HIV-1 antibody in each year was compared.With the positive rate of HIV-1 antibody used as the base,the incidence of new HIV-1 infections among subgroups of HIV-1 antibody positive patients of different types(gender,age,occupation,etc.)was compared.Results From 2016 to 2022,there were 233552 blood samples from voluntary blood donors in Huzhou,including 15 HIV-1 antibody positive samples,with infection rate of 6.42/100000,among which 40.00%were newly infected and 60.00%were previously infected.From 2016 to 2022,the HIV-1 infection rate showed a downward trend year by year as 1.62%,1.24%,0.63%,0.31%,0.30%,0.28%and 0.27%,respectively.The comparision of new infection rate of HIV-1 in different subgroups of 15 HIV-1 antibody positive patients showed that the new infection rate of HIV-1 in repeated blood donation subgroup was higher than that in the first-time blood donation subgroup,with no statistical difference(P>0.05).The incidence of new HIV-1 infections in males was higher than that in females,but there was no statistically significant difference between groups(P>0.05).Among HIV-1 antibody positive blood donors with different educational backgrounds,the proportion of newly infected individuals with junior high school or below was relatively high,but there was no difference compared to other educational subgroups(P>0.05).There was no statistically significant difference in the incidence of new HIV-1 infections among different occupational subgroups(P>0.05).Conclusion In recent years,the incidence of HIV-1 new infections in Huzhou has decreased year by year,and there is no obvious distribution characteristics of new infections in the subgroups of first-time blood donation and repeated blood donation subgroups,as well as subgroups of different genders,educational backgrounds and occupations.