本文選題：無償獻(xiàn)血者　切入點(diǎn)：HIV　出處：《中國輸血雜志》2015年09期

【摘要】：目的研究本市無償獻(xiàn)血HIV篩查及確認(rèn)結(jié)果,為科學(xué)合理制定血液篩查策略,評(píng)估、選擇血液篩查試劑、灰區(qū)設(shè)置合理性提供依據(jù)。方法統(tǒng)計(jì)本中心2013年1月-2014年12月HIV初篩反應(yīng)性獻(xiàn)血者的基本信息、2種ELISA檢測(cè)試劑的S/CO值、核酸篩查及免疫印跡確認(rèn)結(jié)果。結(jié)果本中心在此期間共檢測(cè)標(biāo)本231 832份,EIA+/NAT+標(biāo)本185例,EIA+/NAT-標(biāo)本382例,NAT+/EIA-標(biāo)本4例。送EIA+標(biāo)本479例到區(qū)疾控中心確認(rèn),確認(rèn)陽性152例(均為EIA雙試劑反應(yīng)性),其中男性133例,女性19例,同時(shí)合并梅毒感染19例;確認(rèn)為不確定的標(biāo)本88例,其中雙試劑呈反應(yīng)性的標(biāo)本5例,有3例核酸鑒別為陽性;確定陰性標(biāo)本239例。114例EIA+標(biāo)本經(jīng)第3種EIA第4代HIV試劑和核酸篩查結(jié)果為:均呈反應(yīng)性24例,上�？迫A和生物梅里埃雙試劑呈反應(yīng)性1例,上�？迫A單試劑呈反應(yīng)性7例,上海生物梅里埃單試劑呈反應(yīng)性21例,法國伯樂單試劑呈反應(yīng)性61例。結(jié)論 1遍酶免加1遍核酸檢測(cè)能更很好地避免HIV窗口期及完美控制者的漏檢;在蛋白免疫印跡法(WB)和核酸檢測(cè)確認(rèn)陽性標(biāo)本的檢出上,EIA進(jìn)口第4代HIV試劑相比第3代國產(chǎn)試劑,無明顯優(yōu)勢(shì),相反假陽性極高;HIV陽性無償獻(xiàn)血者的主要傳播途徑為性傳播,且男男同性戀間的性傳播尤為突出。加強(qiáng)高危性行為對(duì)血液安全(尤其是感染窗口期)的宣傳,增加必要的前端篩查,讓以體檢為目的的高危性行為者主動(dòng)放棄獻(xiàn)血,建立以固定獻(xiàn)血為主的獻(xiàn)血招募更有利于血液安全。
[Abstract]:Objective to study the results of HIV screening and confirmation of unpaid blood donation in our city, so as to scientifically and reasonably formulate blood screening strategies, evaluate and select blood screening reagents. Methods from January 2013 to December 2014, the basic information of reactive blood donors for HIV screening and the S/CO values of two kinds of ELISA detection reagents were statistically analyzed. Results the results of nucleic acid screening and Western blotting. Results during this period, a total of 231,832 specimens of EIA / Nat were detected in our center. 185 samples of EIA / Nat were detected. 4 cases of Nat / EIA- specimens were detected. 479 samples of EIA were sent to the CDC for confirmation. The positive results were confirmed in 152 cases (including 133 males, 19 females and 19 patients with syphilis infection), 88 cases of which were confirmed as uncertain specimens, 5 cases of which were positive with double reagents. Three cases of nucleic acid were identified as positive, and two hundred and thirty-nine samples of negative EIA were screened by the fourth generation HIV reagent and nucleic acid of the third kind of EIA. The results showed that all of them were reactive in 24 cases, and the reactivity of Shanghai Kehua and Bio-Meridier in 1 case. The reactivity of Shanghai Kehua single reagent was found in 7 cases, and that of Shanghai Bio Merier reagent was 21 cases. The reactivity of single reagents in France was found in 61 cases. Conclusion Enzyme-free and one-pass nucleic acid detection can better avoid the missed detection of HIV window period and perfect control. There was no significant advantage in the detection of WB- and nucleic acid positive specimens from the fourth generation of HIV compared with the third generation of domestic reagents. On the contrary, sexual transmission was the main route of transmission of non-remunerated blood donors with very high false positive HIV. And the sex transmission between gay men is especially prominent. Strengthen the propaganda of high risk sex behavior to blood safety (especially infection window period), increase the necessary front-end screening, so that high-risk sex behavior for the purpose of physical examination can voluntarily give up blood donation. The establishment of blood donation recruitment based on fixed blood donation is more beneficial to blood safety.
【作者單位】： 重慶市血液中心;重慶市渝中區(qū)疾控中心;
【分類號(hào)】：R457.1;R512.91

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