Transfusion Transmitted Infections in Armed Forces: Prevalence and Trends

Background

This study presents data on the prevalence rate of infectious markers among voluntary and replacement donors in the blood transfusion service in Armed Forces from 2000 to 2004.

Methods

39,646 units of blood were collected from donors during the period from 2000 to 2004. All the samples were screened for hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV) 1&2, hepatitis C virus (HCV), and by venereal disease research laboratory test (VDRL).

Results

24,527 (61.9%) were voluntary donations and 15,119 (38.1%) replacement donations. Prevalence of HBsAg had decreased, amongst voluntary donors from 1.67% to 0.77% but the positivity rate has not showed significant change. Seropositivity of HIV had decreased both in voluntary and replacement donors to 0.22% and 0.86% respectively. The seropositivity for anti-HCV showed steady decrease amongst voluntary donors from 0.46% to 0.20% in 2004, but in replacement donors, there was an increase in reactivity rate from 0.43% to 0.65%.

Conclusion

The increased seropositivity for HCV, HIV and HBsAg could be decreased by introduction of nucleic acid amplification testing (NAT) in minipools for HCV and HIV and introduction of anti-HBcAg (IgM) for hepatitis B virus (HBV) infection. But this may not be possible in near future in developing countries due to financial constraints. At present implementation of strict donor criteria and with use of sensitive laboratory screening tests it is possible to reduce the incidence of transfusion transmitted infections (TTI) in Indian scenario.Key Words: Transfusion transmitted infections, Human immunodeficiency virus, Hepatitis C virus, Hepatitis B virus     

温州市无偿献血者血液艾滋病、梅毒、丙肝、乙肝感染情况调查

目的分析本市献血者艾滋病病毒（HIV）、梅毒螺旋体、丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）感染情况。方法对温州市中心血站2009年1月～2011年12月无偿献血者血液检测情况进行回顾性统计分析。结果丙氨酸氨基转移酶（ALT）不合格率为1.66%,梅毒抗体不合格率为1.39%;乙型肝炎病毒表面抗原不合格率为1.24%,丙型肝炎病毒抗体不合格率为0.79%,人类免疫缺陷病毒抗体不合格率为0.66%,总检测不合格率为5.74%,并呈逐年上升趋势。结论无偿献血总不合格率呈上升趋势,ALT阳性是血液报废的最主要因素,血液梅毒抗体检测的阳性率逐年增高,是目前仅次于ALT阳性而造成血液报废的重要因素。     

献血者中抗-HCV和HBsAg阳性与ALT水平相关性研究

目的探讨无偿献血者丙氨酸氨基转移酶(ALT)异常与HBsAg和丙型肝炎病毒(HCV)感染及非病理因素的关系。方法对242480例献血者标本进行检测,统计ALT、HBsAg和抗-HCV阳性不合格项目的构成比,分析ALT水平与HBsAg和HCV感染的相关性。结果 ALT水平与HBsAg阳性显著相关(r=0.6140,P<0.005),与抗-HCV阳性呈低度相关(r=0.3684,P<0.001)。结论 ALT水平与HCV和HBsAg感染呈正的直线相关。     

无偿献血者HBsAg、抗-HCV、梅毒、抗-HIV检测结果分析

目的：了解雅安市2007-2009间无偿献血人群HBsAg、抗-HCV、梅毒、抗-HIV的感染率变化情况。方法：回顾性分析我站2007-2009间无偿献血人群HBsAg、抗-HCV、梅毒、抗-HIV的检查结果并将结果作统计分析。结果：无偿献血人群2007-2009年HBsAg淘汰呈递减趋势;抗-HCV淘汰呈递减趋势;梅毒淘汰2007—2008呈递增趋势,2008-2009递减趋势有的增加;抗-HIV初筛阳性和确诊阳性均呈递增趋势。结论：雅安市2007—2009年间无偿献血人群HBsAg、抗-HCV、梅毒、抗-HIV的感染率有的递增,有的降低,但均在较低的范围内。     

Infectious Disease Markers in Blood Donors

Background

The infectious disease markers for which blood donors are screened include anti-human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), rapid plasma reagin (RPR) card test for syphilis and malarial parasites.

Methods

A total of 6751 donors were screened over three years to assess the prevalence of infectious disease markers. Screening for anti-HIV I and II, HBsAg and anti-HCV was carried out by enzyme linked immunosorbent assay (ELISA). Syphilis was tested using RPR card test. Malarial parasite was tested by detection of genus specific plasmodium lactate dehydrogenase.

Result

The overall seropositivity for anti-HIV I and II was nine (0.13%), for HBsAg 67 (0.99%), for anti-HCV 13 (0.19%) and for syphilis 42 (0.62%). No sample showed malarial parasites. There was no significant difference (p>0.05) in the seropositivity of various markers between voluntary and replacement donors. There was a significant decline (p<0.05) in the prevalence of seropositivity for HCV and syphilis, but not for HIV and HBsAg over the three year period of the study.

Conclusion

The prevalence of infectious disease markers was similar to that reported by other studies. However, no significant difference was seen in the marker positivity in voluntary and replacement donors, which is at variance from other studies.Key Words: Infectious disease, Blood donors     

病毒核酸检测对降低输血传播疾病残余风险的分析研究

目的：探讨核酸扩增技术（NAT）对降低输血传播疾病残余风险的可行性。方法（1）采用2种不同厂家的酶联免疫吸附试验（ELISA）试剂同时对无偿献血者血液乙肝病毒表面抗原（HBsAg）、丙肝抗体（抗-HCV）、艾滋病抗体（抗-HIV）进行检测;（2）采用血筛系统检测单人份 HBV DNA、HCV RNA、HIV RNA;（3）对 ELISA 检测阴性、NAT 检测阳性的标本定期进行追踪分析,观察有无血清学转换,以确定感染状态。结果共筛查2011年3月-10月乌鲁木齐地区无偿献血者14696例,其中 ELISA 检测阳性共152例（其中2份标本 HBsAg、抗-HCV 同时阳性）：HBsAg 阳性率为0．52％（76/14696）,抗-HCV 阳性率为0．37％（55/14696）,抗-HIV 阳性率为0．16％（23/14696）;NAT 检测阳性共71例：HBV DNA 阳性率为0．22％（32/14696）,HCV RNA 阳性率为0．17％（25/14696）,HIV RNA 阳性率为0．10％（14/14696）;14544例 ELISA 阴性标本经 NAT 检测没有检出 HCV RNA、HIV RNA 阳性标本,检出2例 HBV DNA 阳性标本,经过追踪分析,第1例发生了血清学转换,为“窗口期”感染,第2例无血清学转换,但乙肝核心抗体持续阳性,为隐匿性乙型肝炎。结论ELISA 检测后血液安全性有了很好的保障,但是依然存在输血传播疾病残余风险,NAT 检测可降低输血残余风险,提高输血安全。     

滨海地区无偿献血者乙型肝炎和丙型肝炎流行情况调查

目的:了解滨海地区无偿献血者乙型肝炎和丙型肝炎流行情况。方法:采用回顾性调查方法,对塘沽中心血站自2004年1月至2007年10月无偿献血者捐献的53034例血液的检验结果进行分析。结果:无偿献血者HBsAg及抗-HCV阳性率逐年降低,男性无偿献血者HBsAg阳性率高于女性,抗-HCV阳性率略低于女性。18岁～28岁无偿献血者HBsAg阳性率最高,29岁～38岁无偿献血者抗-HCV阳性率最高,且ALT水平与抗-HCV的关联程度大于HBsAg。结论:通过建立一支固定的无偿献血队伍,加大血液筛检力度并确定合理的正常标准值,可以确保血液质量、减少献血后浪费。     

滨海地区无偿献血者乙型肝炎和丙型肝炎流行情况调查

目的：了解滨海地区无偿献血者乙型肝炎和丙型肝炎流行情况。方法：采用回顾性调查方法，对塘沽中心血站自2004年1月至2007年10月无偿献血者捐献的53034例血液的检验结果进行分析。结果：无偿献血者HBsAg及抗-HCV阳性率逐年降低，男性无偿献血者HBsAg阳性率高于女性，抗-HCV阳性率略低于女性。18岁～28岁无偿献血者HBsAg阳性率最高，29岁～38岁无偿献血者抗-HCV阳性率最高，且ALT水平与抗-HCV的关联程度大于HBsAg。结论：通过建立一支固定的无偿献血队伍，加大血液筛检力度并确定合理的正常标准值，可以确保血液质量、减少献血后浪费。     

Hepatitis C virus infection in patients with sickle cell anaemia at the Lagos University Hospital

The objective of this studies is to determine the frequency of antibodies to Hepatitis C virus (anti-HCV), (2) assess the role of blood transfusion in transmission of infection, and (3) evaluate the clinical implication of anti-HCV sero-positivity in patients with Sickle cell anaemia (SCA). Two hundred and seventy-eight (278) patients with SCA were evaluated by questionnaire interviews for risk factors, clinical examination and serum testing for anti-HCV using a third generation ELISA kit. The overall anti-HCV prevalence was 5.0% (14/278). Anti-HCV was positive in 7% (5/76) of never transfused compared with 5% (9/202) of previously transfused sicklers. (p = 0.5). Clinically, splenomegaly alone or in combination with hepatomegaly was associated with a positive anti-HCV (p = 0.04 and 0.01 respectively). Anti-HCV was detected in 5% of adult patients with Sickle cell anaemia, especially in patients with persistent splenomegaly alone or in combination with hepatomegaly. Blood transfusion did not appear to be the major route of HCV transmission.     

1992～2000年血友病甲患者HCV、HBV、HIV和梅毒感染情况调查分析

目的:了解血友病甲患者丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)、艾滋病病毒(HIV)及梅毒的感染情况。方法:对1992年～2000年山东省血液中心确诊和治疗的162例血友病甲患者进行了抗-HCV、HBsAg、丙氨酸氨基转移酶(ALT)、抗-HIV和梅毒抗体血清学检测,并随机选择1000例无偿献血者作为正常对照。结果:162例血友病甲患者抗-HCV、HBsAg和ALT阳性率分别为20.73％(33/162)、4.32％(7/162)和8.64％(14/162);无偿献血者抗-HCV、HBsAg阳性率和ALT异常率分别为3.00％(30/10000)、10.00％(100/1000)和2.00％(20/1000);血友病甲患者和无偿献血者抗-HIV和梅毒抗体阳性率均为0。结论:血友病甲患者抗-HCV阳性率和ALT异常率高于无偿献血者(x~2 分别为 82.04和21.65,P <0.05),BHsAg阳性率低于无偿献血者(x~2=6.72,P <0.05),血友病甲患者和无偿献血者均无HIV和梅毒阳性反应。     

血清丙型肝炎病毒抗体在消化系统疾病中的流行率

应用抗ＨＣＶ酶联免疫分析试验药盒对２４０例消化系统等疾病作抗ＨＣＶ测定，其中测性迁延性肝炎３１例，慢性活动性肝炎１９例，失代偿期肝硬变５８例，原发性肝癌５０例，慢性浅表性胃炎１０例，消化性溃疡１３例，进展期胃癌１１例，血液透析者３１例，以及其他消化系统病１７例，另外，４１例健康献向员作为对照组，各组血清抗ＨＣＶ阳性率分别抗ＨＣＶ阳性率分别为３５．４％、３１．６５、８．６％、１０．０％、０．０％、１     

Seroprevalence of hepatitis B and hepatitis C in patients with thalassemia and sickle cell anemia in a long-term follow-up

BACKGROUND: Transfusion-dependent patients are more prone to acquiring various transfusion-transmitted infections such as hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). The aim of the study was to investigate the prevalence of these infections in patients with thalassemia and with sickle cell anemia (SCA) receiving multiple blood transfusions. METHODS: The subjects of the present study were 399 multi-transfused patients with beta-thalassemia major or intermedia and SCA who have been registered at the two regional hemoglobinopathy centers in Turkey since 1996. Hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (anti-HCV) and human immunodeficiency virus antibodies (anti-HIV) tests were assayed by a second-generation enzyme-linked immunosorbent assay method. RESULTS: Of the 399 patients, 3 were HBsAg positive (0.75%), 18 were anti-HCV positive (4.5%), and none was anti-HIV positive. All patients with HBsAg and 14 (77.7 %) patients with HCV received initial blood transfusions before second-generation tests were performed. Patients who were anti-HCV positive had a significantly higher mean number of blood transfusions and peak serum alanine transaminase level than anti-HCV-negative patients. CONCLUSIONS: These results showed that after introduction of more sensitive screening tests and stringent donor selection procedures, incidence of HCV infection was significantly reduced, but there was still a serious risk for HCV infection, and there was a minor risk for HBV infection in patients with thalassemia and SCA.     

对HBsAg和抗-HCV ELISA筛查阳性献血者进行确认试验分析

目的 探讨对HBsAg和抗-HCV ELISA筛查阳性献血者进行确认试验分析的意义。方法分别采用中和试验对ELISA检测HBsAg阳性献血者和重组免疫印记试验(RIBA)对抗-HCV阳性献血者进行确认检测，并对确认试验阴性献血者进行NAT检测。结果38693份献血者中，ELISA筛查出HBsAg和抗-HCV阳性分别为381(0．98％)份和173(0．45％)份。在ELISA筛查出的381份HBsAg阳性献血者中，经中和试验确认HBsAg阳性352份，29份为阴性；173份抗-HCV阳性献血者中，RIBA试验确认79份阳性。59份阴性。35份为可疑；29份中和试验确认HBsAg阴性标本和94份RIBA确认抗-HCV阴性或可疑的标本．NAT检测HBV DNA和HCV RNA均为阴性。结论对献血者进行HBsAg和抗-HCV确认试验能够避免假阳性结果的发生，有利于保护献血者的利益和推动志愿无偿献血事业的开展。     

2010～2012年太原市无偿献血者血液检测结果分析

目的分析太原市无偿献血者血液筛查情况,为全市安全用血、节约资源提供科学依据。方法采用SPSS13．0软件对2010～2012年太原市无偿献血者血液筛查项目ALT、HBsAg、抗-HCV、抗-HIV、TP等的检测结果进行分析。结果三年间共筛查血液标本246799份,其中不合格标本14429份,ALT、HBsAg、抗-HCV、抗-HIV、TP不合格率分别为3．24％、0．75％、0．94％、0．60％、0．23％,其中ALT最高。结论对无偿献血者进行严格血液筛查是保证临床用血安全的基础,也是提高合理利用血源的重要措施。     

分析重庆市HIV/AIDS患者合并HBV、HCV感染状况

目的 分析重庆市艾滋病病毒感染者(HIV)和获得性免疫缺陷综合征(acquired immunedeficiency syndrome,AIDS)患者(简称HIV/AIDS患者)合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)状况.方法 利用《艾滋病综合防治系统——抗病毒治疗管理》数据库,回顾收集重庆市2004-2015年HIV/AIDS治疗患者基本情况和HBsAg、Anti-HCV实验室检测结果,利用SPSS 19.0统计软件进行统计分析.结果 截至2015年12月31日,重庆市HIV/AIDS患者中HBsAg和(或)Anti-HCV总检测率55.1％ (11 231/20 397),其中HBsAg和Anti-HCV都进行检测的患者有9 307例.HIV/HBV、HIV/HBV/HCV、HIV/HCV合并感染的比例分别为9.8％、0.9％、4.5％.HIV/HCV合并感染在30 ～ 45岁年龄段构成比最高;HIV/HBV合并感染在男性中构成比最高,与HIV单纯感染组比较,差异均具有统计学意义(P＜0.05).HIV/HBV合并感染及HIV单纯感染均在性传播中构成比最高,差异无统计学意义(P=0.177);HIV/HCV和HIV/HBV/HCV合并感染在静脉吸毒中构成比最高,与HIV单纯感染比较,差异具有统计学意义(P＜0.05).主城9区中HIV/AIDS患者及合并感染患者比例最高.合并感染组病死率均高于HIV单纯感染组,HIV/HBV/HCV组病死率最高.结论 重庆市HIV/AIDS患者中HBsAg、Anti-HCV检测率较低,不同感染模式具有不同的流行病学特征,且合并感染的病死率较高,需要进一步加强对重庆市HIV/AIDS患者中HBV、HCV合并感染检测率和治疗情况的管理.     

山东省血液中心血液检测不合格情况分析

目的了解山东省血液中心无偿献血者实验室检测不合格情况,为进一步 提高无偿献血资源利用率提供参考。方法回顾性分析2016年1月至2018年12月山东省血液中心对献血人群检测不合格的资料.按模式不同分为快速检测和实验室检测,分析不合格项目的数据。结果献血前快速检测312 780人次,不合格率为5.67%(17 736/312 780);实验室检测不合格率为1.35%(3942291 799) ,呈逐年上升趋势, 2017与2018年的不合格率间比较,差异有统计学意义(P<0.05);不合格率由高到低依次为ALT(0.43%)、HBsAg(0.29%) .抗-TP(0.27%)、HIV/抗HIV(0.13%) .抗-HCV0.119%) .异常终止(0.09% )和NAT(0.03%);ALT和异常终止不合格率呈逐年上升趋势,HBsAg和HIV抗HIV不合格率呈逐年下降趋势,梅毒和核酸检测不合格率呈先升后降趋势,抗-HCV不合格率呈先降后升趋势。结论ALT .抗-TP和HBsAg不合格是导致实验室检测不合格的主要原因,采前快检工作有待进一步改进。     

抗-HCV不同试剂检测结果分析

目的探讨不同检测方法、试剂对丙型肝炎病毒（HCV）抗体检测结果的影响。方法以不同试剂采用酶联免疫吸附试验（ELISA）对献血者血浆标本进行抗-HCV检测,呈反应性标本采用HCV RNA RT—PCR荧光定量确证检测。结果ELISA再次检测抗HCV抗体阳性率明显低于初次检测阳性率,差异有统计学意义（P〈0．01）,确证试验阳性率低于初次检测和再次检测的阳性率,差异有统计学意义（P〈0．05）。结论ELISA测定结果为HCV抗体阳性者应经HCVRNART—PCR荧光定量加以确认。     

血液病患者HCV感染状况的初步研究

采用上海科华实业生化公司的抗丙型肝炎(科华抗 HCV)第二代酶联免疫吸附实验试剂,对67例血液病患者进行了抗 HCV 筛选,其中16例抗 HCV 阳性,检出率为23.9%。血友病患者检出率高达83.3%,急性白血病为27.3%,再生障碍性贫血为23.1%。输血少于10次者抗 HCV 阳性检出率为12.8%,多于10次者为39.3%,两组差异有显著性意义(P<0.001)。7例未接受输血者抗HCV 均为阴性,多次输血后复查,其中6例转为阳性,两者差异也有显著性意义(P<0.001)。67例中,HBV/HCV 二重感染6例(9%)。对献血员作抗 HCV 筛选,可能有助于减少输血后肝炎的传染。     

116例血清中HCV RNA定量检测与抗-HCV结果对比分析

目的探讨丙型肝炎病毒抗体(抗-HCV)和HCVRNA定量检测阳性结果对丙型肝炎诊断治疗的临床意义。方法采用第三代ELISA夹心法检测抗-HCV，荧光定量PCR法检测HCVRNA检测116例血清抗-HCV或HCVRNA阳性标本。结果在116例标本中，抗-HCV( )／HCVRNA( )双阳性者83例，抗-HCV( )／HCVRNA(-)者12例，抗-HCV(-)／HCVRNA( )者21例)。两者阳性符合率为71．6％(83／116)。在HCVRNA定量阳性结果中，则有104例为HCV感染，其中抗-HCV的阳性检出率为80．0％(83／104)。随着血清HCVRNA滴度的增高，抗-HCV的阳性率也增加，两者变化趋势一致。结论抗-HCV检测，HCVRNA荧光定量PCR法检测均有一定的局限性，同时应用抗-HCV和HCVRNA检测对临床上完善HCV诊断、评价抗病毒疗效更为准确。