青岛地区无偿献血者血液病毒核酸检测的研究

目的调查青岛地区现有的血液检测体系是否存在输血传播HBV、HCV和HIV的残余风险。方法对无偿献血者样本ELISA法检测HBsAg、抗-HCV和抗-HIV的同时,应用NAT技术检测HBV、HCV和HIV。NAT检测阳性ELISA HBsAg阴性或NAT检测阴性ELISA HBsAg阳性的样本,进一步跟踪确认。结果12 000人份无偿献血者血样未发现ELISA法检测抗-HCV和抗-HIV阴性,NAT检测HCV和HIV阳性的情况,发现2例HBV DNA阳性HBsAg阴性。1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc均为阴性,跟踪11周后采血检测HBV DNA阳性,HBsAg、HBeAg和抗-HBc阳性。另1例HBV DNA阳性,乙肝免疫检测HBsAg、抗-HBs、HBeAg、抗-HBe均为阴性,抗-HBc为阳性,跟踪3周后采血检测,2次检测结果相同,HBV DNA定量检测均为1000IU/ml左右的低含量。结论现有的血液检测体系存在输血传播HBV风险,原因可能为HBV的免疫"窗口期"、隐匿性HBV感染等,建议现有的血液检测体系下,为了阻断HBV的输血传播,增加HBV的病毒核酸检测和抗-HBc检测。     

AIDS awareness in blood donors in North India

SUMMARY. Prevention of AIDS can only be achieved by a successful public awareness programme. This study was carried out to establish the level of awareness of AIDS and HIV infection through blood transfusion among Indian blood donors of various socioeconomic groups. A questionnaire consisting of 20 questions pertaining to various aspects of AIDS and HIV infection was circulated to 1012 voluntary blood donors. The responses were categorized as good, average and poor knowledge according to the number of correct responses. The majority of the donors were males (93.5%), married (69.7%) and belonged to the Hindu community. Of the donors, 44.4% were educated, 49.9% were highly educated and 5.8% were illiterate. Overall, only 205 (20.3%) showed good awareness of AIDS and the majority of these 168 (16.6%) were highly educated. Approximately 80% of our population did not have sufficient knowledge about AIDS or the danger of contracting as well as disseminating this disease in the community.
One hundred and ninetyone (18.9%) donors were in the higher income group and only 13 of them showed good awareness. Most of the donors, 384 (38.0%), were government white collar workers and belonged to the middle income group. In this group 154 had good awareness.
The majority of donors with good awareness (176 out of 205) preferred to receive HIVtested banked blood or blood from their own relatives during emergencies. None of the blood donors had any knowledge of autologous blood donations.
This study showed that awareness of AIDS was not satisfactory in Indian society. More intensive public awareness campaigns by the Government with the help of Non-Governmental Organizations is required in India to prevent an explosive AIDS situation in the near future.     

Two HBV DNA+/HBsAg− blood donors identified by HBV NAT in Shenzhen, China

Background

In order to further improve blood safety, mini-pool (MP) nucleic acid testing (NAT) was implemented to screen samples negative for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency virus (anti-HIV), syphilis (anti-Treponemal antibody) and with normal ALT.

Study design and methods

From August 2006 to February 2008, 41,301 donations were screened using commercial HIV/HCV RNA and HBV DNA Real-Time PCR NAT assays in pools of 8. Reactive pools were re-tested as individual samples using the appropriate screening test and confirmed using an alternate commercial NAT assay. Donors reactive on both NAT assays were considered ‘confirmed’ positive for the virus concerned and recalled for additional follow-up testing and counseling.

Results

Of the 41,301 samples screened, no HIV or HCV RNA-positive/seronegative donations were detected but two HBV DNA positive/HBsAg negative blood donors (Donors 1 and 2) were identified. Their respective hepatitis immunological markers were: Donor 1 - anti-HBc positive/anti-HBe positive/HBeAg negative/ALT normal and HBV DNA viral load of 112 IU/ml; Donor 2 - anti-HBc positive/anti-HBe negative/HBeAg negative/ALT normal and HBV DNA viral load 2750 IU/ml.

Conclusions

MP NAT identified two HBsAg negative donors with presumed occult infection but no HIV or HCV seronegative/NAT positive (yield) donors. The HBV yield rate of 1 in 20,650 (95%CI - 1 in 5663 to 1 in 75,303) is comparatively high, exceeds the predicted rate based on previous modeling for the population and demonstrates the incremental blood safety value of NAT in countries where HBV is highly epidemic. The low viral load of the two yield samples underscores the importance of optimizing the sensitivity of the HBV NAT assay selected for screening.     

HIV testing in India

The National AIDS Control Organization (NACO) has initiated programs for HIV/AIDS control in India. Algorithms for HIV testing have been developed for India. NACO programs have resulted in HIV situation improving over the last decade.     

Co-infection of blood borne viruses in blood donors: A cross-sectional study from North India

Background

There are several studies on prevalence of individual infectious disease markers (mono-infection) in donors but none on prevalence of coinfection. Co-infection is significant as it leads to accelerated disease progression. We, therefore, evaluated the prevalence of co-infection among blood donors.

怒江州无偿献血者HIV感染情况调查

怒江州地处西南边陲,地理环境恶劣,经济文化较落后,改革开放进程较缓慢。1999年发现首例HIV感染,为杜绝HIV经输血传播,本站自2003年7月建站起,即开始对无偿献血者做HIV筛查。1材料与方法1.1调查对象2003年7月~2004年12月来本站的无偿献血者1564名(表1),取其初、复检血液为检测标本。1.2方法与试剂初、复检分别为上海科华和英科新创的抗-HIV ELISA试剂,均为批批检产品,并在有效期内使用。凡初、复检抗-HIV单边或双边阳性者,若复查后结果仍相同,则送血清标本至省艾滋病防治检测中心进一步确认。2结果(表1)表1 2003年7月~2004年12月献…     

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.     

HBsAg阴性献血者人群HBV感染的检测和输血残余风险分析

目的 了解献血人群乙型肝炎病毒(HBV)感染状况和血液经酶免疫法(EIA)筛查乙型肝炎病毒表面抗原(HBsAg)后经血传播HBV感染的残余风险.方法 采用国产和进口两种EIA试剂对献血者血液进行HBsAg筛查,罗氏诊断COBAS Ampliscreens NAT血筛系统检测EIA检测合格标本中HBV DNA,对HBV DNA阳性标本进行半套式PCR检测,并对PCR扩增产物进行测序和病毒基因亚型分析.结果 共筛查1998～2008年的献血者232 305例,发现HBsAg阳性2 999例,阳性率为1.3%;对2002～2007年EIA检测合格的113 639例献血者血液标本进行NAT检测,检测出13份HBV DNA阳性、HBsAg阴性的献血者血液,HBV残余风险高达1.1/10 000.结论 EIA筛查后血液安全性有了很好的保障,经血传播HBV残余风险依然处于较高的水平,NAT应用对提高血液安全,降低输血传播HBV残余风险意义重大.     

湛江市无偿献血者血液检测结果分析

目的分析无偿献血者血液检测结果,为招募安全献血者提供依据及减少血液报废,确保临床用血安全。方法对湛江市近5年来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4.11%,乙型肝炎病毒表面抗原不合格率为0.53%,丙型肝炎病毒抗体不合格率为0.40%,人类免疫缺陷病毒抗体不合格率为0.08%,梅毒抗体不合格率为0.65%;总检测不合格率为5.57%。结论 ALT阳性是血液报废的最主要因素,梅毒抗体的阳性率逐年增高,成为仅次于ALT阳性而造成血液报废的重要因素。     

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。     

柳州市无偿献血者 HIV 感染流行病学分析

目的：了解柳州市无偿献血者 HIV 感染流行病学特征,为采供血机构献血招募提供依据,降低输血传播 HIV 的风险。方法对2008～2012年无偿献血者 HIV 感染进行流行病学调查,分析其感染特征。结果柳州市无偿献血者 HIV 感染不同年份间差异无统计学意义（P ＞0．05）;5年间男女性别、不同年龄段、已婚与未婚间差异有统计学意义（P ＜0．01）;其中初中以下学历占52．94％;56．21％的感染者为性传播。结论柳州市无偿献血者 HIV 感染以青壮年男性、初中以下文化人员为主,并以异性性传播为主。在献血者招募工作中要有针对性排除有高危行为的人群献血,尽量在低危人群中采集血液。     

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。     

芜湖地区无偿献血者HIV筛查策略及确认结果分析

目的分析芜湖地区无偿献血者中HIV感染情况,为完善献血招募策略和临床安全用血提供有效数据。方法选取2017年1月~2020年9月芜湖地区全部无偿献血者中HIV筛查反应性标本,送检至市疾控中心进行确认试验。利用受试者工作特征曲线(ROC曲线)比较酶免试剂的准确性;通过ELISA检测最适临界值分析血清学灰区设置;比较确认阳性、阴性和不确定标本的初筛S/CO值,使用SPSS 22.0软件分析差异显著性。结果送检75例HIV初筛反应性标本:确认阳性17例,17例不确定,41例阴性。4代抗-HIV ELISA试剂的曲线下面积(AUC)大于3代试剂,在准确性上4代试剂更优于3代试剂;17例确认阳性标本均是双试剂反应性高S/CO值,其初筛S/CO值显著高于确认阴性和不确定标本初筛值(P<0.05),确认阴性和不确定结果的S/CO值没有统计学差异(P>0.05)。结论芜湖地区无偿献血者中HIV感染率处于全国中等水平;血清学检测的灰区设置意义不大;应通过规范的献血前干预、灵敏的核酸检测技术和共享区域数据平台等措施进一步保障血液安全。     

合肥地区无偿献血人群HIV的检测及流行病学研究

目的了解合肥地区无偿献血人群HIV感染状况和流行病特点,为献血者招募和血液检测方案建立提供依据。方法采用两种血清学试剂对献血者进行筛查,2012年开始同时用核酸检测系统检测标本中HRV RNA,血清学阳性的标本送到市疾控中心做确认。结果血清学共筛查献血者495 279例,确认阳性44例,阳性率0.9;NAT检测标本112 940,确认阳性20例,全部为血清学双试剂阳性标本。结论合肥地区无偿献血人群HIV感染呈逐年上升趋势,必须采取有效措施保证血液安全。     

郑州市无偿献血者核酸检测的应用及分析

目的通过对郑州地区献血者进行酶免筛查后再实施核酸检测(NAT),探讨增加NAT在临床输血中的必要性及可行性。方法采用罗氏全自动核酸筛查系统和上海科华全自动核酸筛查系统检测HBV DNA、HCV RNA、HIV RNA,样本混合分别采用6人份×166.7μL及8人份×180μL汇集(称为1个pool),如果混检阴性,则直接出具结果;如混检阳性,再进行二次拆分检测,以拆分结果报告最终结果。结果罗氏系统共检测ELISA阴性标本115 227份,其中混检阳性pool 130个,经拆分80个pool为反应性,反应性标本86例,拆分率为61.5%,标本阳性率0.75‰;科华系统共检90 359份ELISA阴性标本,混检阳性pool 93个,经拆分31个pool为反应性,反应性标本31例,pool拆分率33.3%,标本阳性率为0.34‰。二者总计共检标本205586份,反应性标本117例,标本阳性率0.57‰,其中1例为HIV"窗口期"感染。结论核酸检测可以有效降低酶免漏检造成的输血风险,进一步保障输血安全。     

上海地区无偿献血者乙肝病毒核酸检测分析

目的了解无偿献血者乙肝病毒核酸筛查(NAT)阳性人群特点,为血液安全策略提供参考。方法无偿献血者血液经Murex和科华HBsAg ELISA试剂检测,结果为阴性的血液使用cobas TaqScreen MPX试剂进行HBV DNA,HCV RNA,HIV RNA 3项联合核酸检测。对于MPX反应性标本,使用COBAS AmpliPrep/TaqMan进行核酸鉴别试验,同时使用罗氏ECL电化学发光检测系统进行乙肝补充血清学试验。结果 2011年11月1日～2012年1月31日3个月共有献血者86 375人(次),其中有63 351人(次)为初次献血者,HBsAg反应性为1.04%,23 024人(次)为重复献血者,HBsAg反应性为0.46%,两者差异有统计学意义(χ2=63.63,P0.05)。84 990份HBsAg、抗-HCV、抗-HIV1/2阴性血液进行MPX核酸检测,共发现52例(0.060%)HBV DNA阳性,均为低拷贝,含量为(20～200)IU/ml间,其中32例(0.051%)来自初次献血者,20例(0.087%)来自重复献血者,两者比例差异无统计学意义(χ2=3.65,P0.05),没有发现HCV RNA与HIV RNA阳性。结论重复献血者HBsAg反应性比率低于初次献血者;HBsAg阴性献血者HBV DNA阳性率为0.060%,重复献血者HBV DNA阳性率与初次献血者比较,两者差异无统计学意义;开展HBV核酸检测能够进一步保障血液安全。     

佛山地区无偿献血人群人细小病毒B19感染情况分析

目的了解佛山地区无偿献血人群人细小病毒(HPV)B19感染现状。方法采用ELISA检测血液中的HPV B19IgG和IgM抗体,并用PCR检测抗体阳性标本HPV B19DNA。结果 368例无偿献血者标本中检出HPV B19IgG阳性92例,阳性率为25.00%;检出HPV B19IgM阳性2例,阳性率为0.54%,两者比较差异有统计学意义(P0.01)。94例抗体阳性标本中,检测HPV B19DNA阳性4例,阳性率为4.26%。结论佛山地区无偿献血人群存在较高的HPV B19既往感染率,急、慢性感染率较低,慢性感染者HPV B19病毒载量较低。     

2008~2012年东莞市无偿献血者血液筛查的不合格结果分析

目的分析东莞市无偿献血者血液筛查的不合格结果,为提高血液筛查效率提供参考依据。方法对2008～2012年共358080例为谳血前经HBsAg以及／或ALT初筛合洛的献血者衄蘅斯引伪啼查（包括ALT、HBsAg、抗．HCV、抗．HIV、抗-TP）,再对327761例常规筛查合格献血者应用核酸扩增技术（NAT）作进一步筛查。结果ALT初筛后ALT异常仍为首要不合格因素;HIV确证阳性率呈上升趋势;除抗．HIV不合格率外,其他不合格率随文化程度的上升而下降;男性献血者的总不合格率、HBsAg不合格率以及抗-HIV不合格率高于女性,抗．HCV不合格率无性别差异,女性献血者抗-TP不合格率高于男性;18～25周岁献血者的总不合格率最低;NAT筛查共检出265例HBVDNA阳性献血者,HBVDNA阳性率为0．081％（265／327761）。结论制定适合的ALT初筛阈值,招募低危献血者,开展NAT筛查。     

河南省18家血站2017~2019年HIV/HBV/HCV核酸单独阳性结果趋势性分析

目的分析河南省不同地区HIV/HBV/HCV核酸阳性献血者的流行情况,为疾病防控及建立全省统一的核酸检测质量控制标准提供依据。方法统计河南省18家血站2017~2019年检出的核酸单阳性标本的数量及其阳性率,分析其变化趋势;并根据核酸检测混检拆分率,分析各实验室以及各检测系统的核酸检测质量情况。结果河南省18家血站2017~2019年共计检测标本3 501 251例,核酸单独阳性标本中HBV 2 606例(流行率74/10万)、HCV 21例(流行率0.63/10万)、HIV 34例(流行率1.00/10万)。HBV核酸单独阳性标本的阳性率全省总体数据呈上升趋势,HIV和HCV核酸单独阳性标本的阳性率3年无明显差异。核酸检测系统Ⅰ、Ⅱ、Ⅳ、Ⅴ为混检系统,混检阳性5 595例,拆分阳性2 661例,拆分阳性率为47.56%,其中核酸检测系统Ⅰ、Ⅱ、Ⅳ、Ⅴ的混检拆分率分别为39.63%~47.95%、40.43%~54.36%、51.61%、70.00%~45.45%。核酸检测混检拆分呈上升趋势的为B、D、E、F、I、K、L和Q 8家实验室,呈下降趋势的为A、C 2家实验室。核酸检测系统Ⅲ为单人份核酸检测系统,只有C实验室使用,其联检阳性率为0.19%(282/145 474),鉴别阳性率为46.45%(131/282)。结论河南省血站核酸检测单独阳性标本以HBV为主,且多呈逐年上升趋势。不同实验室核酸检测质量管理存在差异,提示应加强实验室质量管理。