重庆市无偿献血者HIV筛查及确认结果对比分析

发布时间：2018-03-30 22:30

本文选题：无偿献血者　切入点：HIV　出处：《中国输血杂志》2015年09期

【摘要】：目的研究本市无偿献血HIV筛查及确认结果,为科学合理制定血液筛查策略,评估、选择血液筛查试剂、灰区设置合理性提供依据。方法统计本中心2013年1月-2014年12月HIV初筛反应性献血者的基本信息、2种ELISA检测试剂的S/CO值、核酸筛查及免疫印迹确认结果。结果本中心在此期间共检测标本231 832份,EIA+/NAT+标本185例,EIA+/NAT-标本382例,NAT+/EIA-标本4例。送EIA+标本479例到区疾控中心确认,确认阳性152例(均为EIA双试剂反应性),其中男性133例,女性19例,同时合并梅毒感染19例;确认为不确定的标本88例,其中双试剂呈反应性的标本5例,有3例核酸鉴别为阳性;确定阴性标本239例。114例EIA+标本经第3种EIA第4代HIV试剂和核酸筛查结果为:均呈反应性24例,上海科华和生物梅里埃双试剂呈反应性1例,上海科华单试剂呈反应性7例,上海生物梅里埃单试剂呈反应性21例,法国伯乐单试剂呈反应性61例。结论 1遍酶免加1遍核酸检测能更很好地避免HIV窗口期及完美控制者的漏检;在蛋白免疫印迹法(WB)和核酸检测确认阳性标本的检出上,EIA进口第4代HIV试剂相比第3代国产试剂,无明显优势,相反假阳性极高;HIV阳性无偿献血者的主要传播途径为性传播,且男男同性恋间的性传播尤为突出。加强高危性行为对血液安全(尤其是感染窗口期)的宣传,增加必要的前端筛查,让以体检为目的的高危性行为者主动放弃献血,建立以固定献血为主的献血招募更有利于血液安全。
[Abstract]:Objective to study the results of HIV screening and confirmation of unpaid blood donation in our city, so as to scientifically and reasonably formulate blood screening strategies, evaluate and select blood screening reagents. Methods from January 2013 to December 2014, the basic information of reactive blood donors for HIV screening and the S/CO values of two kinds of ELISA detection reagents were statistically analyzed. Results the results of nucleic acid screening and Western blotting. Results during this period, a total of 231,832 specimens of EIA / Nat were detected in our center. 185 samples of EIA / Nat were detected. 4 cases of Nat / EIA- specimens were detected. 479 samples of EIA were sent to the CDC for confirmation. The positive results were confirmed in 152 cases (including 133 males, 19 females and 19 patients with syphilis infection), 88 cases of which were confirmed as uncertain specimens, 5 cases of which were positive with double reagents. Three cases of nucleic acid were identified as positive, and two hundred and thirty-nine samples of negative EIA were screened by the fourth generation HIV reagent and nucleic acid of the third kind of EIA. The results showed that all of them were reactive in 24 cases, and the reactivity of Shanghai Kehua and Bio-Meridier in 1 case. The reactivity of Shanghai Kehua single reagent was found in 7 cases, and that of Shanghai Bio Merier reagent was 21 cases. The reactivity of single reagents in France was found in 61 cases. Conclusion Enzyme-free and one-pass nucleic acid detection can better avoid the missed detection of HIV window period and perfect control. There was no significant advantage in the detection of WB- and nucleic acid positive specimens from the fourth generation of HIV compared with the third generation of domestic reagents. On the contrary, sexual transmission was the main route of transmission of non-remunerated blood donors with very high false positive HIV. And the sex transmission between gay men is especially prominent. Strengthen the propaganda of high risk sex behavior to blood safety (especially infection window period), increase the necessary front-end screening, so that high-risk sex behavior for the purpose of physical examination can voluntarily give up blood donation. The establishment of blood donation recruitment based on fixed blood donation is more beneficial to blood safety.
【作者单位】：重庆市血液中心;重庆市渝中区疾控中心;
【分类号】：R457.1;R512.91

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