献血者梅毒检测结果及预测研究

目的 了解枣庄市无偿献血人员梅毒阳性情况,为临床提供安全的血液.方法 对2008年至2010年梅毒阳性献血员进行流行病学分析,对季度梅毒阳性率建立数学模型并进行预测.结果 3年共检出梅毒阳性202例,其中男性95例,女性107例.2008、2009和2010年梅毒总阳性率分别为2.54‰、3.89‰和4.24‰,年度间比较差异有统计学意义(x2=23.425,P＜0.01).以季度梅毒阳性率建立数学模型,Y=1.601 +0.31x,并对2011年每季度进行预测,1、2、3季度梅毒预测阳性率分别为5.63‰、5.94‰和6.25‰,与同期实际阳性率6.14‰、5.48‰和6.87‰相差不大.结论 无偿献血员中梅毒流行趋于增长.应严格检查,以防梅毒通过血液传播.     

大连地区2010~2012年无偿献血人群梅毒阳性及梅毒HIV双阳调查

目的 了解无偿献血人群的梅毒感染情况,进一步做好血液质量监控,减少因输注全血或血液制品感染经血液传播疾病。方法 对大连市2010~2012年18~55周岁的无偿献血者梅毒检测结果及梅毒感染者的HIV检测结果进行分析。结果 梅毒阳性率为3.76‰~4.58‰,梅毒和HIV两项检测均为阳性的标本占梅毒阳性样本的9.05‰~27.40‰,重复献血者的梅毒阳性率比初次献血者的阳性率低0.02%~0.41%。结论 梅毒的阳性率有微弱的上升趋势,由此可见梅毒的筛查工作是保证血液安全的重要一项。     

大连地区2010～2012年无偿献血人群梅毒阳性及梅毒 HIV 双阳调查

目的：了解无偿献血人群的梅毒感染情况,进一步做好血液质量监控,减少因输注全血或血液制品感染经血液传播疾病。方法对大连市2010～2012年18～55周岁的无偿献血者梅毒检测结果及梅毒感染者的 HIV 检测结果进行分析。结果梅毒阳性率为3．76‰～4．58‰,梅毒和 HIV 两项检测均为阳性的标本占梅毒阳性样本的9．05‰～27．40‰,重复献血者的梅毒阳性率比初次献血者的阳性率低0．02％～0．41％。结论梅毒的阳性率有微弱的上升趋势,由此可见梅毒的筛查工作是保证血液安全的重要一项。     

新余市献血人群梅毒感染状况分析

目的调查分析新余市2006年至2011年献血人群的梅毒感染状,为招募低危无偿献血者提供科学的理论依据。方法对新余市2006至2011年无偿献血标本用两种ELISA试剂进行梅毒抗体检测,检测结果按检测时间、性别、年龄、文化程度及职业分布的不同进行统计学分析。结果新余市2006年至2011年45739名无偿献血者梅毒的感染率为3.69‰;2006年至2010年梅毒感染率逐年下降,但2011年又有所上升;不同年龄段无偿献血者的梅毒抗体阳性率以31～40岁年龄组为最高,为6.68‰;工人梅毒感染率最高,学生梅毒感染率最低。结论切实加强健康教育及性疾病防治知识宣传,扩大宣传层次,加大宣传力度,普及无偿献血知识,提升广大市民对无偿献血的认知度,建立以固定献血者及低危人群为主的无偿献血队伍,血液检测选择特异性好、灵敏度高的筛查试剂,提高梅毒抗体阳性检出率,确保临床输血安全。     

开封市无偿献血者梅毒确认阳性结果的调查分析

目的分析2011～2015年开封市无偿献血人群梅毒确认阳性情况,了解梅毒确认阳性无偿献血者人群特征,为本地区梅毒预防及无偿献血招募工作提供参考。方法无偿献血者血液标本梅毒抗体筛查采用ELISA试验,筛查阳性者送开封市疾病控制中心使用TPPA法进行确认试验,并对不同年份、性别、年龄段进行统计分析。结果 2011～2015年264952例无偿献血者中检出80例梅毒确认阳性,总阳性率3.0/万,其中男性阳性率(2.9/万)略低于女性阳性率(3.2/万),差异有统计学意义(P 0.05);以36～45岁阳性率(4.2/万)为最高,不同年龄段差异有统计学意义(P 0.05);2011～2015年梅毒确认阳性率趋于稳定,差异没有统计学意义(P0.05);首次献血者梅毒确认阳性率为7.4/万,再次献血者梅毒确认阳性率为0.5/万,不同献血次数献血人群梅毒确认阳性率的差异有统计学意义(P 0.05)。结论结合开封市无偿献血人群梅毒确认阳性现状,血站在继续加强梅毒筛查同时,还要从无偿献血招募工作开始把好关,坚持以低危人群为原则,采取有效的献血前健康征询,对于多次献血合格的再次献血者,不能放松征询要求,避免高危行为者参与无偿献血,确保输血安全。     

2008—2010大连地区无偿献血人群中梅毒感染分布情况分析

目的了解大连地区2008—2010年无偿献血人群中梅毒感染情况，能够采取有效的措施，阻断梅毒经血液传播。方法收集大连市2008—2010年无偿献血者血液标本，经EusA方法两种试荆检测，对不同年份、年龄、性别、献血者检测梅毒抗体阳性率进行分析。结果2008—2010年大连市155949无偿献血人群中梅毒抗体阳性率0．46％，其中男性梅毒抗体阳性率为O．49％略高于女性梅毒抗体阳性。摩0．44％，两者之间无明显差异。年龄段在26。35及36～45的梅毒抗体阳性率分别为0．65％。0．52％高于18～25及45以上两个年龄段的O．40％，0．24％。结论2008．2010年大连地区无偿献血人群中的梅毒阳性率保持相对稳定的水平，确保从低危人群采集血液，并建立固定的无偿的献血者队伍，保证临床用血安全。     

常德市无偿献血人群梅毒抗体阳性调查分析

对2006～2011年常德市无偿献血标本223888份的检测结果作回顾性统计分析。结果常德地区2006～2011年无偿献血者梅毒阳性率为0.78%,梅毒抗体阳性总数为1744份,其中男1151份,占66%,女593份,占34%,无偿献血者梅毒抗体阳性率与性别、学历、职业存在统计学差异。为有效降低因梅毒抗体阳性所致的血液报废,节约成本,预防和控制经输血感染梅毒风险,采供血系统采取除针对不同职业、学历的人群开展不同的无偿献血招募、选择国内灵敏度高、特异性强的梅毒检测试剂以及提高工作人员血液检测技术水平等措施外,无偿献血前对血液进行梅毒初筛检测,是有值得探索的。     

梧州市无偿献血者梅毒血清学检测结果分析

目的 了解梧州市无偿献血者梅毒感染情况,为保证临床输血安全提供依据。方法 对梧州市2010年1月至2012年12月无偿献血者的血液检测标本108 879份,进行梅毒传染性标志检测,统计梅毒抗体的阳性数和感染率并进行统计学分析。结果 2010年1月至2012年12月无偿献血者梅毒抗体阳性率为0.59%(643/108 879),其中男性412例、女性231例,不同年龄、性别无偿献血者梅毒血清学阳性率结果比较,差异无统计学意义(P>0.05)。结论 加大无偿献血宣传力度,做好献血前的咨询和体检筛查工作,选择低危行为献血者,对保证血液质量,降低输血传播梅毒风险有重要意义。     

南昌地区无偿献血者梅毒呈反应性改变的回顾性调查

目的 统计本地区无偿献血梅毒假阳性率,分析产生的原因,以便采取措施降低假阳性率,减轻献血者心理负担,减少献血者的流失.方法 采用EIJSA和TPPA方法检测.对梅毒筛查阳性的献血者回访,重新抽血检测,并结合问卷资料进行调查、分析.结果 本地区无偿献血梅毒阳性率为0.33%,假阳性率为0.11%,假阳性人数占阳性人数三分之一.结论 应从多方面调杏分析,才能降低假阳性率的发生,减轻献血者心理负担,减少献血者的流失.     

湛江市无偿献血梅毒血清学分析

有资料显示近几年来梅毒感染率呈明显上升趋势[1],为切实做好无偿献血工作,避免梅毒经血液传播的发生和血液的浪费,现对本市4年来无偿献血梅毒抗体阳性血清特征统计分析如下.     

2008-2012年深圳市无偿献血者梅毒感染调查及输血残余风险评估

目的了解深圳市无偿献血者的梅毒感染情况和评估经血传播梅毒的残余风险。方法对2008-2012年深圳市无偿献血者梅毒螺旋体抗体检测结果进行分析,并运用数学模型法评估输血传播梅毒危险度。结果深圳市无偿献血者梅毒流行率为0．36％,首次献血者和重复献血者梅毒流行率分别为0．66％和0．10％,两者血液输注后传播梅毒的危险度分别为5．16×10-4和0．85×10-4。结论献血者经梅毒筛查后仍存在传播梅毒的残余风险,首次献血者血液传播梅毒的残余风险要高于重复献血者,需采取有效措施降低输血风险。     

2008-2012年浙江省江山市无偿献血者血液梅毒检测情况调查分析

目的 了解浙江省江山市无偿献血者梅毒检测阳性情况,为血站选择低危无偿献血者提供理论依据。 方法 选择2008-2012年浙江省江山市25 450名无偿献血者,运用双抗原夹心酶联免疫吸附试验测定梅毒螺旋体抗体,并进行分组比较和统计学分析。 结果 江山市近5年无偿献血人群梅毒阳性率为0.84%(214/25 450),且各年份的阳性率比较差异无统计学意义(χ2=7.64,P>0.05);男女性别梅毒阳性率比较差异无统计学意义(χ2=1.18,P>0.05);不同年龄组的男女性别阳性率比较,只有51~58岁组男女性阳性率比较差异有统计学意义(χ2=4.32,PP>0.05);各年龄组的献血者阳性率比较差异有统计学意义(χ2=22.91,PP结论 江山市无偿献血者的梅毒阳性率已处于较高水平,为了尽可能避免感染性血液的采集,献血前需做到有效征询,尽可能地排除高危行为史者;发展稳定的固定献血者队伍是血站选择低危献血者的必要措施。     

The increasing prevalence of serologic markers for syphilis among Chinese blood donors in 2008 through 2010 during a syphilis epidemic

BACKGROUND: In China, the growing syphilis epidemic parallels the spread of human immunodeficiency virus (HIV) in the general population. This study evaluated the prevalence and incidence of serologic markers for syphilis among donors at five Chinese blood centers. STUDY DESIGN AND METHODS: We examined whole blood and apheresis donations collected from January 2008 through December 2010. Postdonation testing of syphilis was conducted using two different Treponema pallidum antibody enzyme‐linked immunosorbent assay kits. The prevalence of serologic markers for syphilis (%), and the rate of coinfection with HIV‐1/2, hepatitis B virus (HBV), and hepatitis C virus (HCV) were calculated. A multivariable logistic regression analysis was conducted examining donor characteristics associated with positive syphilis serology. Seroconversion rate and syphilis incidence were estimated. RESULTS: Of 801,511 donations, 60% were from first‐time donors and 40% were from repeat donors. There was a significant increase in syphilis serologic markers among first‐time donors with 0.41, 0.45, and 0.57% positivity over 3 years (p < 0.001). Approximately 2.8, 0.8, and 0.5% of HIV‐1/2–, HBV‐, and HCV‐positive donations also tested reactive for syphilis. Logistic regression results suggest that first‐time donors were nine times more likely to be syphilis positive than repeat donors. Higher syphilis positivity was associated with donors older than 25 years and with less education. Estimated incidence among repeat donations was 33 (95% confidence interval, 29‐39) per 100,000 person‐years. CONCLUSION: The increase in syphilis serologic prevalence reflected the syphilis epidemic in the general population. Without screening, most of these syphilis‐positive donations would get into the blood supply. Thus, during a syphilis epidemic, continued syphilis screening of blood donations may be important to maintain blood safety and public health.     

几种梅毒螺旋体检测方法在献血者血液筛查中的效果评价

目的比较快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体抗体双抗原夹心酶联免疫吸附法(TP-ELISA)、梅毒螺旋体特异抗体颗粒凝集法(TPPA)、梅毒螺旋体特异抗体红细胞凝集法(TPHA)4种梅毒检测方法,选择一种适合血站献血者血液梅毒筛查的模式。方法以RPR和TP-ELISA法对献血者血液标本进行TP感染的初筛检测,再采用TPHA或TPPA微量血凝法进行复检确认,分析初复检试剂检测效果。结果RPR与TPHA检测58586份标本,结果显示二者的阳性符合率为81%(267/331),RPR法漏检64例,漏检率0.11%,出现假阳性22例,假阳性率0.04%,两种检测方法的阳性检出率差异有统计学意义;ELISA和TPPA检测18206份标本,二者的阳性检出符合率为98.2%(109/111),差异无统计学意义(P0.05);ELISA法有2例漏检,漏检率为0.01%,出现假阳性5例,假阳性率0.027%;TPHA和TPPA检测结果差异无统计学意义。结论采用ELISA初筛,TPHA或TPPA复检模式对血液TP感染进行筛查,效果明显,值得推广。     

南京地区无偿献血者梅毒感染趋势调查

目的探讨南京地区2007-2011年无偿献血者不同性别、年龄和职业的梅毒感染者的分布和趋势。方法对用两种不同厂家的TP—ELISA试剂检测的无偿献血者血液标本的结果进行回顾性调查研究,对不同年份、年龄、职业和性别的无偿献血者的梅毒抗体阳性率进行分析。结果南京地区325226人份无偿献血者血液标本的梅毒抗体阳性率为0．42％。其中女性（0．49％）高于男性（0．37％）;小于30岁年龄组的梅毒抗体阳性率为0．26％,远远低于大于30岁年龄组的1．08％;学生的梅毒抗体阳性率为0．14％。结论南京地区无偿献血人群中的梅毒阳性率呈逐年持续增长趋势;为保障临床用血的安全性与可持续性,学生、军人及其他小于30岁的公民应为献血招募的主要对象。     

Syphilis and blood donors: What we know, what we do not know, and what we need to know

The lack of transfusion-transmitted syphilis in the United States in the past 30 years has led us to question the rationale for continued syphilis testing of blood donors. In addition, the significance of a confirmed positive syphilis test result in a blood donor is not clear. The following 2 questions have been raised: (1) Are we detecting any truly infectious donors? and (2) If not, what is the significance of a confirmed positive test for syphilis in contemporary blood donors? This review will summarize what is and what is not known about syphilis testing in blood donors and will discuss the need for further research to answer these questions.     

Predictive value of past and current screening tests for syphilis in blood donors: changing from a rapid plasma reagin test to an automated specific treponemal test for screening

BACKGROUND: This study evaluated the change from a rapid plasma reagin (RPR) test to an automated specific treponemal test (PK-TP) in screening for syphilis in blood donors. STUDY DESIGN AND METHODS: A cross-sectional seroprevalence analysis was performed on 4,878,215 allogeneic blood donations from 19 American Red Cross Blood Services regions from May 1993 through September 1995. Positive predictive values relative to the confirmatory fluorescent treponemal antibody absorption test (FTA-ABS) were calculated. Differences in seroprevalence were compared in RPR and PK-TP tests for 1) unconfirmed and confirmed tests, 2) first-time and repeat donors, and 3) "recent" versus "past" infections. Donation data from three additional Red Cross regions were evaluated for repeat donation patterns of blood donors who had a donation that was positive in a serologic screening test for syphilis. The value of RPR and PK-TP tests as surrogate markers for HIV infection was compared. RESULTS: Reactive rates were lower but the positive predictive values was higher for the PK-TP test than for the RPR test. Initially, donors screened by PK-TP were more likely to be confirmed as positive than were donors screened by RPR, but these rates became comparable. It is estimated that a single HIV window-period donation was removed by serologic testing for syphilis each year of this study period. CONCLUSIONS: The change to the PK-TP test resulted in a lower repeatedly reactive rate, better prediction that a confirmed-positive test for syphilis would occur in testing in the FTA-ABS, fewer donations lost, and comparable deferral rates. Because of the high rate of reactivity to serologic testing for syphilis among donors previously confirmed positive for syphilis, indefinite deferral after a confirmed-positive index donation may be warranted. Serologic testing for syphilis is ineffective as a marker of HIV-infectious window-period donations.     

江苏地区献血者隐匿性HBV感染情况调查

目的调查无偿献血人群中隐匿性乙型肝炎病毒的携带率,病毒载量与血清学标志物检出的关系。方法对无偿献血者血液进行ELISA检测后,再行HBV、HCV、HIV核酸检测(NAT)。ELISA阴性、NAT阳性样品再进行HBVDNA、HCV RNA、HIV RNA定量检测及HBsAg、HBsAb、HBeAg、HBeAb、HBcAb化学发光法检测。结果共检测51 248份献血者血液样品,检出41例隐匿性HBV感染者,其携带率为0.80‰;血浆HBV病毒载量均小于66IU/ml;HBcAb阳性者23例,占56.1%;HBcAb伴HBsAb阳性者14例,占34.1%;HBsAb阳性4例,占9.7%。HBsAb或伴HBcAb阳性组与单一HBcAb阳性组相比,HBV DNA含量的差异无统计学意义(P<0.05)。结论江苏地区无偿献血者中隐匿性HBV感染率约为0.80‰;其HBV病毒载量均较低,且血清学标志物的检出模式与病毒载量无相关性。     

2009—2011年度日照市无偿献血者梅毒抗体阳性率回顾性研究

目的了解日照无偿献血者2009—2011年梅毒感染情况,通过加强对献血者献血前问询和评估,控制梅毒经血液传播,降低梅毒输血感染风险。方法用ELLSA两步法不同厂家试剂检测同一标本,两次检验都有反应性的经TPPA确认判为阳性,利用监测数据对献血者血液检测结果进行分析。结果2009—2011年日照市无偿献血者共69872例,经TPPA确认．2009、2010、2011年梅毒抗体阳性率分别为0．38％、0．33％、0．26％,呈逐年下降趋势。结论梅毒抗体阳性率在日照市无偿献血者申呈逐年下降趋势,经统计分析在年龄、职业、学历和献血次数分布上有显著差异。     

Seropositivity for syphilis among Brazilian blood donors. A retrospective study 2015–2020

IntroductionSyphilis is a transfusion-transmitted infection and the disease re-emerged in many countries, including Brazil, as a public health risk.ObjectiveEvaluate the prevalence of positive serology in blood donations rejected by Hemobanco (Curitiba- PR) from January 2015 to December 2020, with special focus in syphilis.MethodologyIn the studied period, we analyzed the number of blood donations discarded annually for each serological test performed on blood donors’ samples, according to gender and donors age.ResultsWithin the studied period, 134,741 blood donation were analyzed. 54.5 % of sample were male. Otherwise, it was observed a significant increase in the number of donations by females (P < 0.0001). There was an increase of 437 % in the prevalence of syphilis positive serology made by donors with ≥ 60 years. Besides that, it was noticed a significant increase in donations by aged people throughout these six years (P < 0.0001). The percentage of total blood donation deferred had a significant reduction, although it was observed an increase in the rate of discarded blood bags due to positive serology in the first 4 studied years. It was observed an increase of 20 % in positive syphilis serology.ConclusionThe greatest cause of discard of blood donations changed during the analyzed 5-years; there was an increase in seropositivity donations from donors with ≥ 60 years old. In 2015, Hepatitis B (0.8 %) was the most prevalent and in 2020, syphilis became more prevalent (0.82 %). The medical community should be aware of the rising number of cases of syphilis infection. There is an urgent need to implement actions against the dissemination of this disease.