构建献血者监测系统阻断输血传播HIV的策略

发布时间：2018-03-05 17:23

本文选题：HIV　切入点：输血传播　出处：《中国输血杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的了解浙江省无偿献血者中HIV流行情况和风险因素,探讨阻断输血传播HIV策略。方法通过浙江省血液管理信息系统(BIS)收集汇总2007-2016年浙江省12家采供血机构5 950 755(人)次无偿献血者HIV标志物筛查结果的资料,统计分析献血者HIV初筛阳性率、流行率、传播途径以及,以及采供血机构保密性弃血与献血者屏蔽中与HIV相关的原因。结果最近10年浙江省无偿献血者HIV初筛阳性率约0.15%(9171/5 950 755),由2007年的0.29%(1 539/523 326)降至2016年的0.11%(675/637 414),HIV流行率约为0.015%(864/5 950 755),由2007年的0.006%(31/523 326)增加至2016年的0.017%(111/637 414)。感染者依据性别或献血次数划分,男性占90.5%(782/864),首次献血者占75.7%(654/864);按年龄划分21-30岁者占58.9%(509/864);传播途径中,性接触占89.7%(775/864),男男同性传播占比51.7%(447/864),男男同性传播的90%(402/447)是学生感染者;按受教育程度划分,高中学历者占49.9%(431/864)、引起保密性弃血的原因:"多个性伴侣"占45.2%(508/1 123)、"性病史"44.0%(495/1 123)和"男男同性接触"6.6%(74/1 123);保密性弃血献血者和未要求保密性弃血献血人者HIV和梅毒感染率、流行率分别为0.267%(3/1 123)vs 0.014%(861/5 949 632)、0.356%(4/1123)vs 0.099%(5 861/5 949 632)(P0.05)。献血者被永久屏蔽原因:"多个性伴侣"占31.7%(89/281)、"性病史"24.9%(70/281)和"男男同性接触"26.3%(74/281);但其中约有0.005%(281/5 950 755)的人隐瞒实情,再次到其他血站参加无偿献血。结论浙江省无偿献血者HIV流行率逐年递增,现行HIV初筛阳性献血者永久淘汰制度不合理。构建区域性联合屏蔽为主的献血者监测系统可以有效阻止潜在的高危献血者在异地献血。
[Abstract]:Objective to investigate the prevalence and risk factors of HIV in unpaid blood donors in Zhejiang province. To explore the strategy of blocking blood transfusion transmission of HIV. Methods the data of screening results of HIV markers in 12 blood collection and donor organizations in Zhejiang Province from 2007 to 2016 were collected and summarized through the blood management information system of Zhejiang Province. The positive rate of HIV screening, prevalence rate, transmission route and, Results in the last 10 years, the positive rate of HIV screening among free blood donors in Zhejiang province was about 0. 15%, 9171 / 5 950 755%, from 0. 29% 1 539/523 326 in 2007 to 0. 11% 675% 637 414% in 2016 in Zhejiang province. Results the positive rate of HIV screening in Zhejiang pro bono donors in the last 10 years was about 0. 115% 675% 637 41414%, down from 0. 29% 1 539/523 326 on 2007 to 0. 11% 675% 637 414% on 2016. The ratio of 0.015% to 5,950,755% increased from 0.006 1 / 523,326 on 2007 to 0.0171% 637,414% on 2016. The infected persons were divided according to sex or number of blood donations. Men account for 90.578 / 864, for the first time, 75.754 / 864; for 21-30, 58.9 / 864; for those aged 21-30, 89.777 / 864; for male same-sex transmission, 51.744 / 864; for male same-sex transmission, 90 / 402 / 447) are student infections; by educational level. High school students accounted for 49.9% 43.1% 864%, causing confidentiality to abandon blood: "multi-personality partners" accounted for 45.2% 50 / 1 123%, "sexual history" 44.0% 44.05 / 1 123) and "male male contact" 6.6% 74% 1 123%; confidential blood donors and those who did not ask for confidentiality to abandon blood donors; and syphilis infection rates. The prevalence rate was 0.2677 / 1 123 vs 0.014 861 / 5 949 632 / 0.3566 / 0.9999 / 12 vs 0.09999 / 949 632 / 0.055.The reasons for the permanent shielding of blood donors were: "Multi-Personality partner" accounted for 31.789 / 281 / 281, "sexual history" 24.999 / 70 / 281) and "male / male contact" 26.374 / 281; but about 0.00555 / 2815 / 950755 / 755 were concealed. Conclusion the prevalence rate of HIV among unpaid blood donors in Zhejiang Province is increasing year by year. The current system of permanent elimination of HIV positive blood donors is unreasonable, and the establishment of a regional joint screening monitoring system for blood donors can effectively prevent potential high risk donors from donating blood in different places.
【作者单位】：浙江省血液中心;金华市中心血站;
【分类号】：R457.1;R512.91

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