Santé publique France, Direction des Maladies Infectieuses, Saint-Maurice, France.
Santé publique France, Direction Appui, Traitements et Analyses de données, Saint-Maurice, France.
Transfusion. 2020 Mar;60(3):525-534. doi: 10.1111/trf.15677. Epub 2020 Feb 6.
Blood donation deferral for men who have sex with men (MSM) in France was reduced from permanent to 12 months in July 2016. To inform a further reduction of the deferral period, an HIV risk assessment was conducted with two scenarios: S1, 4-month deferral; S2, 4-month deferral only in the case of more than one sexual partner (i.e., similar to other blood donors).
Baseline HIV residual risk (RR) was calculated from July 2016 to December 2017, using the Incidence Rate-Window Period method. The impact of both scenarios on RR was assessed using data from surveys on MSM and blood donors, to estimate 1) the number of additional MSM expected to donate in each scenario and 2) HIV incidence among these donors.
Baseline HIV RR was estimated at 1 in 6,380,000 donations. For S1, an additional 733 MSM donors, and an additional 0.09 HIV-positive donations were estimated, yielding an unchanged RR of 1 in 6,300,000. For S2, these numbers were estimated at 3102 and 3.92, respectively, yielding an RR of 1 in 4,300,000. Sensitivity analyses showed that, under worst-case assumptions, the RR would equal 1 in 6,225,000 donations for S1 and 1 in 3,000,000 for S2.
For both scenarios, the HIV RR remains very low. For S1, the risk is identical to the baseline RR. For S2, it is 1.5 times higher, and sensitivity analysis shows that this estimate is less robust than for S1. The French Minister of Health announced that S1 will be implemented in April 2020.
2016 年 7 月，法国将男男性行为者（MSM）的献血延期从永久性改为 12 个月。为了进一步缩短延期时间，进行了艾滋病毒风险评估，设定了两种方案：方案 1，4 个月延期；方案 2，仅在有多个性伴侣的情况下（即类似于其他献血者），4 个月延期。
使用发病率-窗口期法，从 2016 年 7 月至 2017 年 12 月计算出 HIV 基准残留风险（RR）。使用 MSM 和献血者调查的数据评估两种方案对 RR 的影响，以估计 1）每种方案中预计有多少额外的 MSM 会献血，2）这些献血者中的 HIV 发病率。
估计 HIV RR 为每 638 万次献血中出现 1 例。对于方案 1，预计会有 733 名 MSM 献血者和 0.09 例 HIV 阳性献血者，RR 保持不变，为每 630 万次献血中出现 1 例。对于方案 2，这些数字分别估计为 3102 和 3.92，RR 为每 430 万次献血中出现 1 例。敏感性分析显示，在最坏情况下，方案 1 的 RR 为每 622.5 万次献血中出现 1 例，方案 2 的 RR 为每 300 万次献血中出现 1 例。
两种方案的 HIV RR 仍然非常低。对于方案 1，风险与基准 RR 相同。对于方案 2，风险是方案 1 的 1.5 倍，敏感性分析显示，与方案 1 相比，方案 2 的估计结果不太可靠。法国卫生部长宣布，方案 1 将在 2020 年 4 月实施。
