比较不同方法筛查无偿献血者人类免疫缺陷病毒抗体的效果

Comparison the effectiveness of different screening methods for human immunodeficiency virus antibodies in unpaid blood donors

目的:分析血站无偿献血者人类免疫缺陷病毒(HIV)抗体采用不同方法筛查的结果,为临床合理选择HIV检测方法提供依据。方法:抽取2022年1至12月在南阳市中心血站无偿献血者血液样本28000份,分别采用酶联免疫吸附法(ELISA)初筛、ELISA复查和核酸检测法筛查HIV抗体,并采用蛋白免疫印迹法进行确证,比较其一致性。结果:初筛28000份无偿献血者血液样本中的HIV抗体,ELISA法测定阳性率为0.100%,ELISA复查阳性率为0.075%,核酸测定阳性率为0.068%;确证试验阳性率为0.050%,0.018%为阴性,0.007%为不确定。ELISA复查阳性、ELISA初筛阳性、核酸阳性与确证试验阳性一致性好。初筛阳性样本中10份(35.71%)确证试验为阳性,其中7份(25.00%)S/CO值为1~<6;17份(60.71%)确证试验为阴性,其中9份(32.14%)S/CO值为1~<6;1份(3.57%)不确定,S/CO值为1~<6。ELISA复查阳性样本中14份(66.67%)确证试验为阳性,其中2份(9.52%)S/CO值为6~<10,12份(57.14%)S/CO值≥10;5份(19.05%)确证试验为阴性,其中3份(14.29%)S/CO值为0.8~<1,1份(4.76%)S/CO值为1~<6,1份(4.76%)S/CO值为6~<10;2份(9.52%)不确定,S/CO值为6~<10。核酸样本14份确证试验为阳性,其中9份(47.37%)S/CO值为1~<6,3份(15.79%)S/CO值6~<10,2份(10.53%)S/CO值为≥10;3份确证试验阴性,其中1份(5.26%)S/CO值为0.8~<1,2份(10.53%)S/CO值为1~<6;2份(10.53%)不确定,S/CO值为1~<6。HIV确证阳性无偿献血者,<35岁占57.14%,首次献血者所占比例更高(85.71%),HIV病毒主要通过性接触进行传播。结论:HIV抗体、核酸检测阳性、确证试验阳性之间保持比较高的一致性,都可以准确检出血液HIV感染;要重视35岁以下和首次献血者的HIV筛查。

Objective:To analyze the anti-HIV screening results of unpaid blood donors in blood stations,and provide the basis for the rational selection of testing reagents in clinical testing.Methods:A total of 28000 blood samples from voluntary blood donors in Nanyang Central Blood Station from January 2022 to December 2022 were selected,and the results of anti-HIV screening and confirmation were analyzed.Results:Among the 28000 blood samples from voluntary blood donors,0.100%were positive in the initial enzyme-linked immunosorbent assay(ELISA)screening,0.075%were positive in the double reagent screening,and 0.068%were positive in nucleic acid testing.The confirmation test results showed that 0.050%were positive,0.018%were negative,and 0.007%were uncertain.ELISA reexamination positive,ELISA preliminary screening positive and nucleic acid positive were consistent with confirmatory test positive.Out of the initial screening positive samples,10(35.71%)confirmed positive results,including 7(25.00%)with S/CO values ranging from 1 to<6;17(60.71%)with negative results,among which,9(32.14%)with S/CO values ranging from 1 to<6;1(3.57%)with uncertain S/CO values ranging from 1 to<6.Among the positive ELISA reexamination samples,14(66.67%)were confirmed to be positive,of which 2(9.52%)with S/CO values ranging from 6 to<10,and 12(57.14%)with S/CO values of≥10;5(19.05%)confirmed tests were negative,of which 3(14.29%)with S/CO values ranging from 0.8 to<1,1(4.76%)with S/CO values ranging from 1 to<6,and 1(4.76%)with S/CO values ranging from 6 to<10;2(9.52%)with uncertain S/CO values ranging from 6 to<10.There were 14 nucleic acid samples confirmed positive,of which 9(47.37%)with S/CO value ranging from 1 to<6,3(15.79%)with S/CO value ranging from 6 to<10,and 2(10.53%)with S/CO value≥10;3 confirmatory tests were negative,of which 1(5.26%)with S/CO values ranging from 0.8 to<1,2(10.53%)with S/CO values ranging from 1 to<6;2(10.53%)was uncertain with S/CO values ranging from 1 to<6.For these HIV positive unpaid blood donors,it was found that 57.14%were younger than 35 years old,and the proportion of the first time blood donors was higher(85.71%).HIV was mainly transmitted through sexual contact.Conclusions:There is a high consistency between the positive anti-HIV,nucleic acid test and the positive confirmatory test,which can accurately detect HIV infection in blood.Emphasis should be placed on HIV screening for people under 35 years old and first time blood donors.