Song Yan, Bian Ying, Petzold Max, Ung Carolina Oi Lam
Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, China.
Center for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
PLoS One. 2014 Apr 8;9(4):e94528. doi: 10.1371/journal.pone.0094528. eCollection 2014.
The prevalence of transfusion-transmissible infections (TTIs) in blood donations is important for evaluating blood safety and potential risks to the population. This study investigated the prevalence of TTIs among blood donors in Western China and suggested measures for policy-makers.
The screening results of 66,311 donations between 2005 and 2010 from a central blood center in Western China were analyzed. The prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis infections were expressed in percentages for the entire study group as well as groups by demographic characteristics and donation frequency, with differences analyzed using Fisher's exact or Chi-square test. Logistic regression was performed to identify the influencing factors of the detected results.
1,769 (2.67%, 95% CI 2.55-2.79%) of the donated blood had serological evidence of infection with at least one pathogen and 44 (0.07%, 95% CI 0.05-0.09%) showed evidence of multiple infections. The seroprevalence of HBV, HCV, HIV, and syphilis infections was 0.87% (95% CI 0.80-0.94%), 0.86% (95% CI 0.79-0.93%), 0.31% (95% CI 0.26-0.35%), and 0.70% (95% CI 0.64-0.76%) respectively. Trend analysis for the prevalence of TTIs showed a significant increase from 2.44% to 3.71% (χ2 = 100.72, p = 0.00) over this 6-year period. The positive rates for TTIs varied along demographic lines. The top three risk factors in test-positive donors were identified as age, education level and donation frequency. The older age group and lower educated group were linked to a higher prevalence of TTIs. A decreasing prevalence was associated with an increasing frequency of blood donations (χ2 = 562.78, p = 0.00).
Hepatitis B and C were found most, and often in conjunction with syphilis. These were the primary threats to blood safety. The high positivity rate and the increasing prevalence of TTIs among blood donors in Western China call for further actions.
献血中输血传播感染（TTIs）的流行情况对于评估血液安全性及对人群的潜在风险至关重要。本研究调查了中国西部献血者中TTIs的流行情况，并为政策制定者提出了措施建议。
分析了中国西部一家中心血站2005年至2010年间66311份献血的筛查结果。以百分比形式呈现整个研究组以及按人口统计学特征和献血频率分组的乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）、人类免疫缺陷病毒（HIV）和梅毒感染的流行情况，采用Fisher精确检验或卡方检验分析差异。进行逻辑回归以确定检测结果的影响因素。
1769份（2.67%，95%可信区间2.55 - 2.79%）献血有至少一种病原体感染的血清学证据，44份（0.07%，95%可信区间0.05 - 0.09%）显示有多重感染证据。HBV、HCV、HIV和梅毒感染的血清流行率分别为0.87%（95%可信区间0.80 - 0.94%）、0.86%（95%可信区间0.79 - 0.93%）、0.31%（95%可信区间0.26 - 0.35%）和0.70%（95%可信区间0.64 - 0.76%）。TTIs流行情况的趋势分析显示，在这6年期间从2.44%显著增加至3.71%（χ2 = 100.72，p = 0.00）。TTIs的阳性率因人口统计学特征而异。检测呈阳性的献血者中排名前三的风险因素为年龄、教育水平和献血频率。年龄较大组和受教育程度较低组与TTIs的较高流行率相关。随着献血频率增加，流行率呈下降趋势（χ2 = 562.78，p = 0.00）。
发现乙型和丙型肝炎最为常见，且常与梅毒同时出现。这些是血液安全的主要威胁。中国西部献血者中TTIs的高阳性率和不断增加的流行率需要采取进一步行动。
