青岛地区无偿献血人群HIV筛查结果回顾性调查

目的了解和掌握青岛地区无偿献血人群HIV感染情况,比较分析3种检测方法的结果,为加强血液管理提供决策依据。方法将本中心2013年6月14日-2014年6月14日采集的血液样本100 885人份进行血清学检测,其中99 637例ALT正常,TP抗体阴性的献血者样本进行了NAT,抗-HIV初筛阳性样本送往市疾病控制中心做确证实验,对3种方法的检测结果进行回顾性分析。结果抗-HIV反应性59例(阳性率为0.06%),其中抗-HIV和核酸同时反应性16例(阳性率为0.016%),43例抗-HIV单项反应性,未检出HIV核酸单项反应性样本,59例经确证阳性18例(感染率为17.84/10万),1例不确定,其中16例抗-HIV和核酸同时反应性样本经确证全部HIV阳性,43例抗-HIV单项反应性确证阳性2例,1例不确定。在16例血清学反应性(S/CO值大于15)、NAT阳性样本中,核酸检测的阳性预测值为100%。流行病学调查发现18例确证阳性献血者全部为男性,未婚11例(61.11%),已婚6例(33.33%),1例不祥;首次献血者8例(44.44%),重复献血者10例(55.56%)。结论 NAT的假阳性率远远低于血清学检测方法,针对HIV感染检测准确度高。为了保证血液质量和输血安全,除了加强实验室管理,提高HIV检测水平,我们应积极普及无偿献血知识和艾滋病相关知识的宣传教育,加强未婚男性青年的艾滋病防治工作。     

无偿献血者HIV假阳性献血员去留的探讨

目的探讨无偿献血者HIV确认为阴性的献血者是否保留、归队为献血者。方法无偿献血者标本（HIV两种试剂检测）仅一种试剂有反应,且A值小于1,乙型肝炎病毒表面抗原、丙型肝炎病毒抗体、梅毒抗体均阴性,转氨酶正常的献血者,于献血后12个月再采集标本做献血常规检测。结果共收集到46份标本,检测结果仅有1份标本进口试剂有反应性,国产试剂均无反应性,将有反应性标本送省疾病预防控制做确认实验,结果为阴性。结论无偿献血者HIV两种试剂检测（一种国产、一种进口）仅有一种试剂有反应性,且A值小于1者,其他项目均正常的献血者,HIV反应性多是假阳性,进一步检测之后,HIV无反应性或确认为阴性的献血者可以保留。     

万州地区无偿献血者HIV感染特征

目的了解万州地区无偿献血者HIV感染特征,有针对性地宣传艾滋病预防知识,从源头控制输血传播艾滋病的风险。方法收集并整理了2006~2013年无偿献血者及其中HIV感染者相关资料,包括HIV感染者的流行病学调查资料,分析其性别、年龄、人群类别和感染途径等特征。结果万州地区2006~2013年无偿献血者HIV感染率平均为21.57/10万,总体呈缓慢增长趋势。无偿献血HIV感染:以男性感染为主;20~29岁感染率最高,达到30.13/10万(26/86 292);小学文化程度者HIV感染率最高,达到134.63/10万(4/2 973),其次是高中和初中文化程度者,分别为31.55/10万(18/57 047)和20.77/10万(12/57 768);剔除商业服务人群外,以农民群体HIV感染率最高,达到259.16/10万(14/5 402),其次是工人(57.74/10万,11/19 051);感染途径以异性传播为主,占70.59%(48/68),其次是男男同性传播(27.94%,19/68),无其他途径感染者。结论结合该地区无偿献血人群HIV感染者性别、年龄、文化及职业等特征,加强对农民和工人等低文化水平人群的艾滋病预防知识宣传,有针对性地加强部分献血者献血前的征询排查,将HIV感染者隔离于献血前,从源头上提高血液安全保障。     

无偿献血HIV抗体初筛阳性确认结果分析

目的分析2009~2015年HIV抗体筛查和确证试验结果,为制订在低危人群中招募献血者的招募策略和献血者回归提供依据。方法采用酶联免疫吸附试验(ELISA)检测HIV抗体,分别用2个不同厂家试剂检测。HIV抗体检测阳性或可疑的标本送深圳市疾病预防控制中心进行免疫蛋白印迹确认。选取2009~2015年血液标本筛查确认结果进行统计分析。结果2009~2015年197 766份血液标本,2009~2015年每年总的感染率分别为1.3/10万、4.7/10万、5.6/10万、5.4/10万、5.3/10万、4.6/10万、7.3/10万,平均感染率为0.004 9%(4.9/10万),平均确诊阳性率为22.1%,假阳性率为77.9%。HIV抗体确认阳性的献血者中年龄18~30岁的占67.7%。结论重视献血前的征询招募工作,针对外来劳务工和文化程度相对低的献血者加强献血知识的普及,特别是有高危行为的献血者,采用小卡片的方式,引导其到疾控中心做专业的咨询检测,既提高输血安全系数又能预防艾滋病扩散。针对假阳性的献血者做好回访跟踪监测及献血资格的回归工作,减少献血者的流失。选择更加灵敏的试剂及选择更加灵敏的病毒核酸扩增的方法,可尽量缩小因窗口期感染的风险,确保输血安全。     

Vasovagal reactions in blood donors during or immediately after blood donation

The aim of the study was to estimate the type, incidence and causes of donor adverse reactions during and after blood donation in a Greek Blood Bank, where medical staff is responsible for donor selection. 12 173 blood donors were studied for adverse reactions. One-hundred and seven (0.87%) donors had a vasovagal reaction during or after blood donation. Donors who gave blood occasionally had a significant greater incidence of reactions compared with volunteer donors (1.15 versus 0.53%) (P < 0.001). There was no significant difference between men and women (0.85 versus 0.95%). First-time donors (1.7 versus 0.68%) and those under 30 years (1.15 versus 0.71%] had a significant greater possibility to have a reaction (P < 0.001). Twenty-two of 107 (20.5%) donors had a syncopal reaction. There was not a causative correlation of haematocrit, haemoglobin, systolic and diastolic blood pressure, pulse rate and weight in women (except weight in men) in developing a reaction. The stressing experience of phlebotomy was the reason for the higher frequency of a reaction. The incidence of reactions in our donors is lower than in other studies, and the possible reason for this is that only physicians are responsible for the selection of donors and trained personnel are careful of them during the donation process.     

2002-2013年福建省血液中心无偿献血者HIV感染现状分析

目的了解福建省血液中心无偿献血者HIV感染现状,更好的制定防控策略,进一步保障临床用血安全。方法对2002-2013年福建省血液中心749 834份无偿献血者血液筛查标本进行HIV项目常规检测,对其中HIV抗体确认阳性的95名无偿献血者的流行特征、趋势和献血史等情况进行调查分析。结果 2002-2013年福建省血液中心无偿献血者HIV抗体确认阳性率从2010年开始阳性率呈现增长趋势始终大于1例/万,2012年和2013年更是高达2.76例/万和2.75例/万;HIV感染者以男性为主,比例为88.4%;年龄分布18-30岁的比例为64.2%;初次献血者和再次献血者比例为2∶1,初次献血者比例为61.1%,再次献血者比例为38.9%;从可能的传播途径上还是性传播为主,比例为84.2%,同性性传播和异性性传播比例为1∶2;从籍贯上分本省和外省的比例为2∶1;献血地点为街头固定采血点为主,比例为87.4%。结论福建省血液中心的献血人群HIV感染率与我国献血人群HIV感染率持续上升的态势基本一致;HIV感染者以男性,30岁以下的献血者为主;性传播是献血者感染HIV的主要途径,再次献血者感染HIV的例数有逐年增加的趋势。     

兰州地区无偿献血人群 HIV 感染状况分析

目的：了解兰州地区无偿献血者艾滋病病毒（HIV）感染情况,有针对性地采取措施,保障血液安全。方法采用2种不同厂家的酶联免疫吸附试验（ELISA）试剂,对献血者标本进行抗-HIV 筛查,初筛阳性标本用免疫印迹法（WB）进行确证试验。结果兰州地区2009年1月至2012年12月抗-HIV 确证阳性32例,平均感染率为0．15‰;男性高于女性;年龄以18～35岁为主;涉及多个行业;学生及高学历人群的感染率有升高趋势。抗-HIV初筛与确证试验的结果符合率较低;随着 S/CO 值的增高,与确证试验的阳性符合率也随之升高。结论兰州地区无偿献血者抗-HIV 阳性率有逐年增高及年轻化的趋势,应加强献血者献血前咨询、筛查及艾滋病防治知识宣传。通过调整检测试剂及方法,提高抗-HIV 初筛与确证试验的结果符合率。探讨献血者的召回及归队策略,在保证血液安全的前提下,减少因假阳性结果造成的献血员流失,稳定无偿献血者队伍。     

某地区重复无偿献血人群分布分析

目的 对2007年1月至2011年12月的18 675例重复无偿献血者人群分布进行分析,探讨安全献血人群和工作模式.方法 对18 675例重复无偿献血者按性别、年龄、献血模式、职业、文化程度进行统计比较.结果 在性别方面,女性高于男性;在年龄方面,18～40岁占80.42%;献血模式方面,自愿无偿献血高于计划指令性献血;在职业方面,学生、军人、公务员占60.45%高于工人;在文化程度方面,以中学和大学生为主占81.34%,重复献血人数显逐年增长趋势.结论 在低危人群中采集相对安全的血液的同时,应进一步加大宣传的力度、广度,不断状大重复献血队伍,促使再次献血转化成固定献血者.     

重庆市无偿献血人群中HIV感染者的流行病学特征分析

目的了解重庆市无偿献血者H IV感染的特征,以降低输血传播H IV的风险。方法收集和整理重庆市2008、2009年无偿献血者中的H IV感染者和重庆市CDC报告的H IV感染者基本信息,分析其感染特征,包括性别、年龄和感染途径。结果重庆市2008、2009年无偿献血人群的H IV感染率分别为55.8/10万(51/91 399)和72.1/10万(72/108 205),高于全市估算的H IV感染率25.6/10万和37.0/10万,无偿献血人群的H IV感染者以18~29岁的年轻人为主,占65.89%,其他年龄段的比例分别为30~39岁占23.26%,40~49岁占7.75%,≥50岁占3.10%。感染途径以男-男性传播方式为最,占50%,异性性传播的比例为47.06%,静脉吸毒传播占2.94%。结论应结合本地区无偿献血人群中H IV感染者的特征,有针对性地加强无偿献血者献血前的咨询和对高危人群的甄别排查,从而确保血液的安全性。     

HIV抗体、HCV抗体联合检测试剂在无偿献血员初筛试验中的应用评价

目的评价人类免疫缺陷病毒（HIV）抗体、丙型肝炎病毒（HCV）抗体联合检测试剂（酶联免疫法）（以下称联检试剂）在无偿献血员初筛试验中应用价值。方法严格按照试剂说明书进行操作，利用已知阳性标本检测联检试剂的敏感性、特异性，评价其与进口参比试剂的差距。结果分别检测HIV抗体、HCV抗体阳性标本各264例，阴性无偿献血员标本88例，联检试剂对于HIV抗体阳性标本的敏感性为100．00％，特异性为98．86％，对于HCV抗体阳性标本的敏感性为99．62％，特异性为98．11％。与进口参比试剂实验结果比较，进行卡方检验P〉0．05，两种试剂无显著差异。结论在无偿献血员初筛试验中使用联检试剂可以使采血单位的工作效率和经济效益得到提高，节省了人力、物力、财力，具有一定的使用前景。     

2006-2008年浙江省温州地区无偿献血者血液传播疾病检测结果回顾性分析

目的分析2006-2008年浙江省温州地区无偿献血人群血液传播疾病检测结果 ,为本地区血液管理工作提供参考依据。方法收集2006年1月1日至2008年6月30日温州地区无偿献血者血液传播疾病检测结果 ,并进行回顾性分析。结果 2006-2008年温州地区无偿献血人群血液传播疾病检测结果不合格率较高,乙型病毒性肝炎病毒表面抗原(HBsAg)阳性率为4.77%(4527/94830),丙氨酸转氨酶(ALT)异常率高达11.50%(10442/90786),艾滋病病毒(HIV)阳性率为0.02%(15/81199),梅毒抗体阳性率为0.30%(243/81199),抗-HCV阳性率为0.45%(363/81199),在抗-HCV阳性人群中,男性阳性率为0.51%(257/50229),高于女性阳性率0.34%(106/30970)(χ2=12.351,P0.001),18～35岁和36～55岁两个年龄段间阳性率比较无差异,无偿献血人数超过1000人的各地区抗-HCV阳性率差异有统计学意义(χ2=22.958,P=0.011),其中河南省抗-HCV阳性率最高(0.81%),显著高于温州地区(χ2=13.594,P0.001)。结论 2006-2008年温州地区无偿献血者血液传播疾病检测结果不合格率较高。HBsAg阳性率为4.77%,低于全国人群普查阳性率;ALT异常率高达11.50%;抗-HCV阳性率为0.45%,男性高于女性,来自河南省的献血人群抗-HCV阳性率高于来自温州本地者。     

True HIV seroprevalence in Indian blood donors

The National AIDS Control Organization (NACO), the apex body for controlling AIDS in India, projected that HIV seroprevalence would increase from 7/1000 in 1995 to 21.2/1000 in 1997. A high incidence (8.2%) of HIV was observed in blood donors. This study was carried out to find out the true HIV positivity in Indian blood donors. Blood donors from our centre were followed for more than 5 years to determine the true HIV seroprevalence and our result was compared with similar studies from India. Voluntary and relative blood donors who visited the SGPGIMS, Lucknow, since 1993 to June 1998 were included. They were screened for HIV 1/2 by ELISA kits (WHO approved). First-time HIV-positive samples were preserved frozen for further study (stage-I). They were repeated in duplicate and retested with other kits. If found positive, the sample was labelled as ELISA positive (stage-II). ELISA-positive samples were confirmed by Western Blot (WB) at stage-III. A total of 65 288 donors were included and 834 (12.8/1000) were reactive at stage-I. But 1.1/1000 donors were found to be ELISA positive at stage-II, and 0.28/1000 donors were positive by WB at stage-III. The 'seropositivity' rate from the NACO was significantly (P < 0.001) higher than our study. There were five similar Indian studies and seropositivity rate varied from 0.72/1000 (using ELISA and WB) to 5.5/1000 (using ELISA alone). The 'seropositivity' rate from the NACO was significantly (P < 0.001) higher than all these studies. HIV seroprevalence in the present study is lower (P < 0.001) than other Indian figures. The present and other studies confirmed that the projected HIV seroprevalence (82/1000) in Indian blood donors was high. The NACO result was based on one-time ELISA screening reports from zonal blood testing centres which also receive samples from paid donors donating in commercial blood banks. The HIV prevalence of blood donors (and national prevalence) is to be reassessed.     

Attitudes towards blood donation and transfusion in Bamenda, Republic of Cameroon

Objectives: This study was conducted in Bamenda, Cameroon. The objectives of the study were to develop a theoretical framework to better understand local attitudes towards blood donation and transfusion, to identify factors that motivate and deter blood donation and to identify interventions to improve the supply of blood for transfusion at Bamenda Regional Hospital. Background: The supply of blood for transfusion in sub‐Saharan Africa is insufficient. Cameroon has no national blood service and the collection and screening of blood is the responsibility of individual hospitals. At Bamenda Regional Hospital patient relatives recruit replacement blood donors, who may or may not be family members, and shortages of blood and delays in transfusion are frequent. Materials and Methods: Qualitative research methods were used: direct observation, in‐depth interviews, focus group discussions and a simulation exercise. Participants were clinical and laboratory staff, patient relatives, blood donors, secondary school students and community members. Results: Attitudes towards blood donation and transfusion fit a transanctionalist framework of health decision making. Deterrents to blood donation are multiple and varied. Some form of compensation is often expected, even by family members, although the blood donation is still considered ‘voluntary’ by the donor. Conclusion: This study confirms that interventions to improve the blood supply must take into account local attitudes and conditions. In Bamenda, a variety of pragmatic approaches are required including education around specific biological misperceptions identified in the study and the retention of replacement donors as repeat donors. Issues around compensation for blood donation require further work.