重庆市无偿献血者HIV筛查及确认结果对比分析  

Investigation of the blood donors' results of blood screening and identification for HIV in chongqing

作　　者：黄秀琳[1] 冷文杰 尹丹[1] 杨虎[1] 毕蕾静 刘东[1] 李维[1] 田耘博[1] 

机构地区：[1]重庆市血液中心,重庆400015 [2]重庆市渝中区疾控中心

出　　处：《中国输血杂志》2015年第9期1128-1130,共3页Chinese Journal of Blood Transfusion

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。Objective To investigate the blood donors＇results of blood screening and identification for HIV in our district, and provide scientific and rational basis for blood screening strategies, selection of blood screening reagent, and assessment rationality of gray areas. Methods Statistics of our center since January 2013 to December 2014 years screening test for HIV reactive donor profiles, S/CO of 2 EIA regents and the results of nucleic acid testing（NAT）and Western blot confirmation . Results There were 231 832 samples during this period, EIA ＋/NAT ＋ 185 specimens, EIA ＋/NAT-382 specimens, specimens of NAT ＋/EIA-4. Send EIA ＋ 479 specimens to CDC for confirmation. Confirmed positive 152 cases （both EIA double reagents reactivity）, 133 males, 19 females and 19 cases of syphilis infection; confirmed uncertain 88 specimens , including 5 specimens double reagents reactivity, there are 3 positive specimens in NAT ; confirmed negative 239 specimens. 114 EIA ＋ specimens by the 3rd EIA 4th generation HIV reagents and NAT results for： 24 cases showed reactivity in all regents, and 1 case showed reactivity in Shanghai kehua and bio-Merieux reagents, 7 cases showed reactivity in Shanghai kehua reagent, 21 cases showed reactivity in Shanghai bio-Merieux reagent, 61 cases showed reactivity in bio-rad reagent. Conclusion EIA and NAT can more effectively prevent HIV window period and perfect control of undetected. On the detection of by protein Western blot （WB） and NAT to confirm positive samples, the dth generation EIA imports reagent was no obvious advantage compared to HIV domestic 3rd-generation reagent , contrary to very high false-positive; The main route of transmission of the HIV-positive blood donors for sexually transmitted, and sexual transmission among gay men is particularly prominent. Strengthening publicity of high-risk sexual behavior on blood safety （ especially infectious window period）, increased necessary front-end screening, the high-risk sexual behaviour people voluntarily ga

关 键 词：无偿献血者 HIV 筛查 确认结果 对比分析 

分 类 号：R457.1[医药卫生—治疗学] R446.6[医药卫生—临床医学]