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[目的]了解深圳无偿献血者HIV感染状况和血液在EIA筛查后经血传播HIV感染的残余风险。[方法]采用EIA方法筛查献血者血液抗-HIV-1/2,罗氏诊断公司COBAS AmpliScreens NAT血筛系统EIA检测“合格”标本中HIV-1RNA,聚合酶链反应(PCR)分离阳性献血者外周血单个核细胞中HIV前病毒DNA,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2002～2008期间的献血者标本152081人份,发现抗-HIV阳性17人份,阳性率为0.011%;对EIA检测“合格”的113639份献血者血液标本进行NAT检测,检测出1份HIV-1RNA阳性但EIA阴性的血清转换窗口期感染漏检的献血者血液,HIV残余风险高达1/113639。15例HIV-1分离株基因分型显示,4例为HIV-1B’亚型,11例HIV-1E亚型,与本地区早期献血者中流行的HIV-1亚型相似。[结论]EIA筛查后血液安全性有了很好的保障,但深圳献血者血液经血传播HIV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HIV残余风险意义重大。
[Objective] To understand the status of HIV infection in unpaid blood donors in Shenzhen and the residual risk of blood-borne HIV infection after blood screening in EIA. [Methods] EIA was used to screen blood anti-HIV-1/2 in blood donors, RIA’s COBAS AmpliScreens NAT blood-screening system was used to detect HIV-1 RNA in the “qualified” samples by EIA, and positive for polymerase chain reaction HIV provirus DNA in peripheral blood mononuclear cells of blood donors, and PCR amplification products were sequenced and analyzed for viral genotypes. [Results] A total of 151,081 blood donors were screened during the period from 2002 to 2008, 17 were positive for anti-HIV, and the positive rate was 0.011%. The blood samples from 113,639 blood donors who tested for EIA were “qualified” One HIV-1 RNA-positive, but not EIA-negative, seroconversion window was detected and detected in blood transfused from undetected donor blood with a residual risk of HIV of 1 in 113639. Genotyping of 15 HIV-1 isolates revealed 4 HIV cases -1B ’subtype and 11 HIV-1E subtypes similar to the HIV-1 subtype prevailing among early blood donors in the region. [Conclusion] The blood safety of EIA screening is well protected. However, the residual risk of blood transmitted by blood donors in Shenzhen is still at a high level. The use of NAT is of great significance to improve blood safety and reduce the residual risk of HIV transmission by blood transfusion.