佛山市无偿献血者人类T淋巴细胞白血病病毒感染情况调查

目的 探讨广东省佛山市无偿献血人群中,人类T淋巴细胞白血病病毒(HTLV)感染状况,评估经血液传播HTLV的风险,保障临床输血安全.方法 选择2016年2月至12月,于佛山市参加无偿献血的69 275例献血者作为研究对象.采用酶联免疫吸附试验(ELISA)法对献血者血浆中HTLV-Ⅰ/-Ⅱ抗体进行初步筛查.对初检结果呈反应性的标本再进行双孔复检.对复检结果呈反应性的标本,则判定为HTLV-Ⅰ/-Ⅱ抗体初筛结果呈阳性.对初筛结果呈阳性的标本采用Western印迹法进行确证.统计不同性别、年龄、学历、户籍及献血次数献血人群的HTLV-Ⅰ/-Ⅱ抗体的初筛阳性率,并且采用统计学方法,分别对不同献血人群的HTLV-Ⅰ/-Ⅱ抗体初筛阳性率进行比较.结果 ①本研究69 275例无偿献血者中,HTLV-Ⅰ/-Ⅱ抗体呈阳性者为17例,HTLV-Ⅰ/-Ⅱ抗体初筛阳性率为0.025％.其中,仅2例献血者的HTLV-Ⅰ/-Ⅱ抗体的Western印迹法确证试验结果呈阳性,确证阳性率为0.003％.②本研究69 275例无偿献血者中,女性献血者的HTLV-Ⅰ/-Ⅱ抗体初筛阳性率为0.042％(11/26 291),高于男性的0.014％(6/42 984),并且差异有统计学意义(x2=5.17,P=0.023).不同年龄段献血者中,46～55岁年龄段献血者的HTLV-Ⅰ/-Ⅱ抗体初筛阳性率最高(0.084％,4/4 768);并且不同年龄段献血者HTLV-Ⅰ/-Ⅱ抗体初筛阳性率总体比较,差异有统计学意义(x2=8.09,P=0.044).不同学历献血者中,初中及以下学历献血者HTLV-Ⅰ/-Ⅱ抗体初筛初筛阳性率最高(0.063％,7/11 113);并且不同学历献血人群HTLV-Ⅰ/-Ⅱ抗体初筛阳性率总体比较,差异有统计学意义(x2 =7.97,P=0.047).外地户籍献血者HTLV-Ⅰ/-Ⅱ抗体初筛阳性率(0.033％,15/45 274)高于本地户籍献血者(0.008％,2/24 001),并且差异有统计学意义(x2=3.93,P=0.047).2次及以上献血者HTLV-Ⅰ/-Ⅱ抗体初筛阳性率(0.034％,16/46 414)高于首次献血者(0.004％,1/22 861),并且差异有统计学意义(x2=5.65,P=0.017).结论 佛山市属于无偿献血人群感染HTLV的低发生率区或者非流行区.女性、老年、学历低、外地户籍及多次献血的无偿献血人群感染HTLV的风险较大.鉴于输血安全,建议献血前常规检测所有无偿献血者的HTLV-Ⅰ/-Ⅱ抗体,同时对血液进行去除白细胞过滤处理.

Investigation of human T-cell lymphocytic leukemia virus infections among voluntary blood donors in Foshan City

Objective To investigate the infection status of human T lymphocyte leukemia virus (HTLV) in voluntary blood donors in Foshan City of Guangdong Province,and to evaluate the risk of HTLV transmission through blood,in order to ensure safety of clinical blood transfusion in Foshan City.Methods From February to December 2016,a total of 69 275 blood donors in Foshan City were selected as study objects.Enzyme-linked immunosorbent assay (ELISA)was conducted to detect HTLV-Ⅰ/-Ⅱ antibodies in plasma from all blood donors,then reactivity samples were double-hole re-examined.The samples which were reactive by double-hole re-examined were determined primary screening results of HTLV-Ⅰ/-Ⅱ antibodies positive.And finally confirmed by Western blotting detection.The primary screening positive rates of HTLV-Ⅰ/-Ⅱ antibodies of blood donors from different gender,age,education degrees,household registration and times of blood donation were measured and compared by statistical method.Results ① In these 69 275 blood donors,HTLV-Ⅰ/-Ⅱ antibodies of 17 donors were positive,and primary screening positive rate of HTLV-Ⅰ/-Ⅱ antibodies was 0.025 ％.Among them,only 2 samples were identified as positive for HTLV-Ⅰ/-Ⅱ antibodies by Western blotting,and confirmed positive rate was 0.003％.② The primary screening positive rate of HTLV-Ⅰ /-Ⅱ antibodies in female donors was 0.042％ (11/26 291),which was higher than that of male donors (0.014％,6/42 984),and the difference was statistically significant (x2 =5.17,P =0.023).The primary screening positive rate of HTLV-Ⅰ/-Ⅱ antibodies in 46-55 years old blood donors was the highest as 0.084％ (4/4 768) among donors of different ages,and the total difference of HTLV-Ⅰ/-Ⅱ antibodies primary screening positive rates in donors of different ages was statistically significant (x2 =8.09,P=0.044).The blood donors with junior middle school education or below has the highest primary screening positive rate of HTLV-Ⅰ/-Ⅱ antibodies (0.063％,7/11 113) among donors of different education degrees,and the total difference of primary screening positive rates was statistically significant (x2 =7.97,P=0.047).The primary screening positive rate of HTLV-Ⅰ/-Ⅱ antibodies in nonlocal registered blood donors (0.033％,15/45 274) was higher than that of local registered donors (0.008％,2/24 001),and the difference was statistically significant (x2 =3.93,P=0.047).The primary screening positive rate of HTLV-Ⅰ/-Ⅱ antibodies in multipe blood donors (0.034％,16/46 414) who donated blood twice or more,was higher than that of the first blood donors (0.004％,1/22 861),and the difference was statistically significant (x2 =5.65,P =0.017).Conclusions The results show that Foshan City belongs to low-incidence or non-endemic area of HTLV infection among voluntary blood donors.The risk of infection with HTLV was higher among female,elderly,low education,nonlocal registered and multipe blood donors.In view of blood transfusion safety,it is recommended that HTLV-Ⅰ/-Ⅱ antibodies of all voluntary donors should be detected before blood donation,and the blood should deal with filter to remove white blood cells.