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目的了解浙江省无偿献血者中HIV流行情况和风险因素,探讨阻断输血传播HIV策略。方法通过浙江省血液管理信息系统(BIS)收集汇总2007-2016年浙江省12家采供血机构5 950 755(人)次无偿献血者HIV标志物筛查结果的资料,统计分析献血者HIV初筛阳性率、流行率、传播途径以及,以及采供血机构保密性弃血与献血者屏蔽中与HIV相关的原因。结果最近10年浙江省无偿献血者HIV初筛阳性率约0.15%(9171/5 950 755),由2007年的0.29%(1 539/523 326)降至2016年的0.11%(675/637 414),HIV流行率约为0.015%(864/5 950 755),由2007年的0.006%(31/523 326)增加至2016年的0.017%(111/637 414)。感染者依据性别或献血次数划分,男性占90.5%(782/864),首次献血者占75.7%(654/864);按年龄划分21-30岁者占58.9%(509/864);传播途径中,性接触占89.7%(775/864),男男同性传播占比51.7%(447/864),男男同性传播的90%(402/447)是学生感染者;按受教育程度划分,高中学历者占49.9%(431/864)、引起保密性弃血的原因:“多个性伴侣”占45.2%(508/1 123)、“性病史”44.0%(495/1 123)和“男男同性接触”6.6%(74/1 123);保密性弃血献血者和未要求保密性弃血献血人者HIV和梅毒感染率、流行率分别为0.267%(3/1 123)vs 0.014%(861/5 949 632)、0.356%(4/1123)vs 0.099%(5 861/5 949 632)(P<0.05)。献血者被永久屏蔽原因:“多个性伴侣”占31.7%(89/281)、“性病史”24.9%(70/281)和“男男同性接触”26.3%(74/281);但其中约有0.005%(281/5 950 755)的人隐瞒实情,再次到其他血站参加无偿献血。结论浙江省无偿献血者HIV流行率逐年递增,现行HIV初筛阳性献血者永久淘汰制度不合理。构建区域性联合屏蔽为主的献血者监测系统可以有效阻止潜在的高危献血者在异地献血。
Objective To understand the prevalence and risk factors of HIV in unpaid blood donors in Zhejiang Province and to explore strategies to block the transmission of blood transfusion. Methods A total of 5 950 755 (person) blood donors from 12 blood collection and supply institutions in Zhejiang Province from 2007 to 2016 were collected and collected from Zhejiang Blood Management Information System (BIS) The positive rate, the prevalence, the route of transmission, and the causes of HIV-related rejection in donating blood donor confidentiality and blood donors. Results The HIV positive rate of unpaid blood donors in Zhejiang Province in recent ten years was 0.15% (9171/5 950 755), down from 0.29% (1 539/523 326) in 2007 to 0.11% in 2016 (675/637 414 ), The prevalence of HIV was about 0.015% (864/5 950 755), increasing from 0.006% (31/523 326) in 2007 to 0.017% (111/637 414) in 2016. The number of infected persons was 90.5% (782/864) for males and 75.7% (654/864) for the first blood donors, while 58.9% (509/864) for those aged 21-30 years by age. Transmission routes Sexual contact accounted for 89.7% (775/864) of the sexes, 51.7% (447/864) for MSM, and 90% (402/447) for MSM were students with HIV / AIDS; according to educational attainment, 49.9% (431/864) of them have high school diplomas, causing the confinement to abandon blood: 45.2% (508/1 123), multiple sex partners, 44.0% (495/1 123) ) And “same sex with men” (6.6%) (74/1 123). The prevalence rates of HIV and syphilis among confidant blood donors and non-confidential blood donors were 0.267% (3 / 1 123) vs 0.014% (861/5 949 632), 0.356% (4/1123) vs 0.099% (5861/5 949 632) (P <0.05). Blood donors were permanently shielded due to: “Multiple sexual partners” accounted for 31.7% (89/281), “STD history” 24.9% (70/281) and “MSM” 26.3% (74 / 281). However, about 0.005% (281/5 950 755) of them concealed the truth and re-donated blood to other blood stations again. Conclusion The prevalence of HIV in unpaid blood donors in Zhejiang Province has been increasing year by year. The current system of permanent elimination of HIV positive screening blood donors is unreasonable. Constructing a regional joint screening-based blood donor monitoring system can effectively prevent potential high-risk blood donors from donating blood off-site.