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近年来,中国的献血者招募模式正在从有偿献血到单位组织献血,进而到完全无偿献血的模式转变。有关真正的无偿献血者中丙型肝炎感染的资料还较少报道。本研究对重庆地区2003年的首次献血者进行丙型肝炎感染及病毒分型的调查,共有13620份血清标本进行ELISA丙型肝炎抗体检测,其中抗体阳性标本再经RT-PCR扩增HCVRNA的核心区/E2区片段进行基因分型。结果发现,HCV抗体阳性率为0.49%(67/13620),其中在40-49岁年龄段的阳性率(0.86%)最高;高学历人群和大城市生活人群的阳性率相对为高。丙肝病毒的基因分型结果显示,在22份基因分型阳性标本中有基因型1b,2a,3a和3b等四种,分别占4(18%)、5(23%)、9(41)和4(18%),以基因型3(包括3a和3b)为流行。结论:重庆地区无偿献血人群中丙型肝炎抗体阳性率较低;由于本地及周边地区静注毒品人群中丙型肝炎感染以基因型3为主,提示可能在献血人群中有静注吸毒者的存在。因此,随着献血模式的转变,在献血者的招募中应注意排除吸毒者这一高危人群。
In recent years, the pattern of recruitment of blood donors in China is shifting from paid blood donation to blood donation organized by the unit, and then to a completely unpaid blood donation. Less information is available on hepatitis C infections in real blood donors. In this study, the first blood donors in Chongqing in 2003 were investigated for hepatitis C infection and virus typing. A total of 13,620 serum samples were tested for hepatitis C antibody. The antibody-positive samples were amplified by RT-PCR Region / E2 region fragments for genotyping. The results showed that the positive rate of HCV antibody was 0.49% (67/13620), of which the highest positive rate was in the range of 40-49 years old (0.86%). The positive rate of HCV antibody was higher in highly educated and metropolitan living population. The results of genotyping of hepatitis C virus showed that there were 4 genotypes 1b, 2a, 3a and 3b in 4 of the 22 genotyping positive samples, accounting for 4 (18%), 5 (23%), 9 (41) And 4 (18%), with genotype 3 (including 3a and 3b) as the epidemic. Conclusion: The positive rate of hepatitis C antibody in blood donors in Chongqing is relatively low. Because genotype 3 is the main cause of hepatitis C infection among local and peripheral intravenous drug users, suggesting that there may be intravenous drug users in blood donors exist. Therefore, with the change of blood donation pattern, the high risk population of drug addicts should be excluded from the recruitment of blood donors.