Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China; Johns Hopkins School of Medicine, Baltimore, Maryland; Westat, Inc., Rockville, Maryland; Guangxi Blood Center, Liuzhou, Guangxi, P.R. China; Kunming Blood Center, Kunming, Yunnan, P.R. China; Urumqi Blood Center, Urumqi, Xinjiang, P.R. China; Mianyang Blood Center, Mianyang, Sichuan, P.R. China; Luoyang Blood Center, Luoyang, Henan, P.R. China; Johns Hopkins School of Public Health, Baltimore, Maryland.
Transfusion. 2013 Oct;53(10 Pt 2):2489-97. doi: 10.1111/trf.12297. Epub 2013 Jun 19.
A total of 2%-2.9% of the population in China is infected with hepatitis C virus (HCV). This study estimated the prevalence and incidence of HCV among Chinese blood donors.
We examined whole blood and apheresis platelet donations at five Chinese blood centers in 2008 to 2010. All donations were screened using two rounds of testing for alanine aminotransferase, antibody to human immunodeficiency virus Types 1 and 2, hepatitis B surface antigen, anti-HCV, and syphilis. Screening reactivity is defined by a reactive result in one or both rounds of screening tests. Confirmatory tests (Ortho third-generation HCV enzyme immunoassay, Johnson & Johnson) were performed on anti-HCV screening-reactive samples. Confirmatory positive rates among first-time donors (prevalence) and repeat donors (incidence) were calculated by blood center and demographic categories. Donor characteristics associated with HCV confirmatory status among first-time donors were examined using trend test and multivariable logistic regression analysis.
Among 821,314 donations, 40% came from repeat donors. The overall anti-HCV screening-reactive rate was 0.48%. Estimated HCV prevalence was 235 per 100,000 first-time donors; incidence was 10 per 100,000 person-years in repeat donors. In multivariable logistic regression analysis, first-time donors older than 25 years displayed higher HCV prevalence than the younger donors. Less education is associated with higher HCV prevalence. Donors 26 to 35 years old and those above 45 years displayed the highest incidence rate.
High prevalence and incidence in donors indicate high residual risks for transfusion-transmitted HCV in Chinese patients. Implementation of minipool nucleic acid testing in routine donation screening may prevent a substantial number of transfusion-transmitted HCV infections.
中国总人口的 2%-2.9%感染了丙型肝炎病毒（HCV）。本研究旨在评估中国献血者中 HCV 的流行率和发生率。
我们在 2008 年至 2010 年期间对中国五个血液中心的全血和单采血小板献血者进行了检测。所有献血者均采用两轮检测进行筛查，检测项目包括丙氨酸氨基转移酶、人类免疫缺陷病毒 1 型和 2 型抗体、乙肝表面抗原、抗 HCV 和梅毒。筛查反应性定义为一轮或两轮筛查试验中出现阳性反应。对抗 HCV 筛查反应性样本进行了确认试验（Ortho 第三代 HCV 酶免疫测定法、Johnson & Johnson）。通过血液中心和人口统计学类别计算首次献血者（流行率）和重复献血者（发生率）的确认阳性率。采用趋势检验和多变量逻辑回归分析，对首次献血者中与 HCV 确认状态相关的献血者特征进行了研究。
在 821314 份献血者中，40%为重复献血者。抗 HCV 筛查反应率总体为 0.48%。估计 HCV 流行率为每 100000 名首次献血者中有 235 例；重复献血者的发生率为每 100000 人年 10 例。在多变量逻辑回归分析中，年龄大于 25 岁的首次献血者 HCV 流行率高于年轻献血者。受教育程度较低与 HCV 流行率较高相关。26 至 35 岁和 45 岁以上的献血者显示出最高的发病率。
献血者中 HCV 的高流行率和发生率表明中国患者的输血传播 HCV 风险仍然很高。在常规献血筛查中实施核酸混样检测可能会预防大量输血传播 HCV 感染。
