深圳地区2003～2014年献血者 HIV 血液筛查结果及其窗口期确认

目的：分析深圳地区2003～2014年无偿献血者 HIV 感染率变化趋势，以及研究 HIV 感染窗口期确认过程。方法2003～2014年共584111例献血者经进口与国产2种 ELISA 试剂及血液病毒核酸（NAT ）检测方法（2006年开始使用）筛查 HIV 项目，抗‐HIV 阳性样品送疾病预防控制中心（CDC）确证，统计分析12年来献血者 HIV 感染流行趋势。另外，使用高灵敏度的荧光定量‐PCR（Rt‐PCR）方法对抗‐HIV 阴性／NAT 阳性样品确认 HIV RNA 的存在并随访跟踪复查，以判定是否为 HIV感染窗口期。结果深圳地区2003～2014年献血人数逐年增长，抗‐HIV 筛查阳性率呈平稳下降趋势，但经 CDC 确认为 HIV 感染的献血者流行率则急剧升高，2014年的献血者 HIV 感染率为2003年的26．61倍；感染 HIV 的献血者中由同性性行为传播的比例逐年升高。通过跟踪复查、Rt‐PCR 检测，4例抗‐HIV 阴性／NAT 阳性样品为 HIV 感染窗口期，深圳地区无偿献血者的 HIV感染窗口期检出率为1／117995（4／471978）。无偿献血者 HIV 感染率在男性组、18～＜39岁组、已婚组、初次献血组分别明显高于女性组、39～＜60岁组、未婚组、重复献血组（P＜0．05），而非该地与该地户籍组比较，差异无统计学意义（P＞0．05）。结论深圳地区的血液筛查机制与手段能较好地杜绝 HIV 感染窗口期带来的输血风险，有效保障输血安全。

HIV blood screening results and its window period confirmation in blood donors in Shenzhen area during 2003 - 2014

Objective To analyze the change trend of HIV infection rate among volunteer donors in Shenzhen area during 2003 -2014 and investigate the confirmation process of HIV window infection period .Methods The HIV screening items in 584 111 blood donors samples were performed by ELISA with both domestic and imported reagents and the viral nucleic acid (NAT ) detection method (starting from 2006) .The samples with anti‐HIV positive were submitted to the center for disease control (CDC) for con‐ducting the confirmation of HIV infection .The prevalent trend of HIV infection rate in blood donors was statistically analyzed .Mo‐reover ,the highly sensitive fluorescent quantitative method (Rt‐PCR) was used to confirm the existence of HIV RNA in the samples with anti‐HIV negative/ NAT test positive and the follow up was performed to conduct the retest for judging whether being the HIV window infection period .Results The number of blood donors was increased year by year during 2003 - 2014 and the positive rate of anti‐HIV screening demonstrated the steadily declining trend ,but the prevalence rate of HIV infected donors confirmed by CDC was sharply increased ,the HIV infection rate of blood donors in 2014 was 26 .61 times of that in 2003 ,among them ,the trans‐mission proportion by homosexual behavior was elevated year by year .Through following up retest and Rt‐PCR detection ,4 samples of anti‐HIV negative /NAT positive were finally identified as the window infection period ,the detection rate of HIV window infec‐tion period in Shenzhen area was 1/117 995(4/471 978) .The infection rate of HIV in the male group ,18 - < 39 years old group , married group and first‐time donor group among voluntary donors were significant higher than that in the female group ,39 - < 60 years old group ,unmarried group and re‐donation group(P < 0 .05) .However ,there was no statistically significant difference be‐tween the locality census register group and local household registration group (P> 0 .05) .Conclusion The blood screening system and measures in Shenzhen area could better eradicate the blood transfusion risk brought by the HIV window infection period and ef ‐fectively ensure the blood transfusion safety .