【摘要】 目的:回顾性调查烟台地区2013—2023年近11年献血人群艾滋病病毒(human immunodeficiency virus, HIV)联合筛查情况，分析筛查及确证阳性结果。为制定有效献血者招募及艾滋病防控策略提供数据支持，探讨新形势下血液安全筛查策略新思路。方法:采用国产两种酶联免疫分析试验(ELISA)、核酸检测(NAT)和电化学发光免疫分析(ECLIA)共3种检测方法进行HIV联合筛查，对筛查反应性标本送本市疾病预防控制中心进行蛋白免疫印迹法(WB)确证，比较3种方法检测结果与确证结果的一致性，并对HIV确证阳性人群按照性别、年龄、职业、民族、学历、献血成分、献血次数等做统计分析。结果:2013—2023年烟台地区献血人群HIV检测4种试剂(3种方法)与确证试验比较均具有一致性，其中NAT与确证一致性极好；献血者657 253份标本共检出HIV初筛阳性404例，初筛阳性率0.61‰,确证阳性104例，确证阳性率为0.16‰;104例HIV阳性中，男性(98.1%)比女性(1.9%)高；35周岁以下人群79例，占比76%,年龄分布差异有统计学意义；初次献血者(51.9%)比重复献血者(48.1%)高，现住本市人群(80.8%)高于非本市人群(19.2%),差异有统计学意义。结论:(1)NAT检测HIV与确证试验的一致性优于ELISA两种试剂和ECLIA法；(2)烟台地区青年男性人群仍是HIV高危人群的集中区，应采取多种渠道加强艾滋病防控工作；(3)初次献血者HIV阳性率高于重复献血者，建议进一步优化献血者宣传招募及捐献流程；(4)采用ELISA双试剂、NAT和ECLIA联合进行HIV筛查，可最大限度降低输血风险，减少HIV假阳性致血源流失。更多还原

【Abstract】 Objective: To review the results of human immunodeficiency virus(HIV) virus screening among blood donors in Yantai from 2013 to 2023, analyze positive and confirm positive results, and provide data support for developing effective donor recruitment and HIV prevention strategies, so as to explore new ideas for blood safety screening strategies in the current situation. Methods: Using three methods—domestic enzyme-linked immunosorbent assay(ELISA), nucleic acid testing(NAT) and electrochemiluminescence immunoassay(ECLIA) for combined HIV screening, reactive specimens were sent to the city’s disease prevention and control center for confirmation using Western blot(WB). The consistency between the results of the three methods and the confirmed results was compared, and statistical analysis was conducted on the confirmed positive HIV cases according to gender, age, occupation, ethnicity, education, blood donation components and number of donations. Results: From 2013 to 2023, HIV testing with four reagents(three methods) in Yantai showed consistent results with confirmation tests, with NAT showing excellent agreement. Among 657, 253 blood samples, 404 tested positive in initial screening(0.61‰ positive rate), and 104 were confirmed positive(0.16‰ positive rate). Among the 104 confirmed HIV-positive cases, 98.1% were male and 1.9% were female. Of these, 79 cases(76%) were under 35 years old, indicating a statistically significant age distribution. First-time donors(51.9%) were more prevalent than repeat donors(48.1%) and the number of current residents(80.8%) was higher than that of non-residents(19.2%), which had statistical signficance. Conclusion:(1)The consistency between NAT testing for HIV and confirmation experiments was superior to that of ELISA with two reagents and the ECLIA method.(2)Young males in Yantai were still the most vulnerable group to HIV infection, and multiple channels should be adopted to strengthen AIDS prevention and control work.(3)The HIV positive rate was higher among first-time blood donors compared to repeat donors. It may be recommended to further optimize the recruitment and donation process for blood donors.(4)Using a combination of ELISA with dual reagents, NAT and ECLIA for HIV screening can minimize transfusion risks and reduce the loss of blood supply due to false positives.更多还原