Analysis of HIV detection status and tracking status of single-reagent reactive blood donors in Yinchuan area
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摘要: 目的 通过对艾滋病病毒抗原/抗体(HIV-Ag/Ab1+2)单试剂反应性献血者进行追踪、检测, 为献血者归队的可行性提供依据。方法 收集2022—2023年因HIV-Ag/Ab1+2检测单试剂反应性被屏蔽献血者85例, 电话召回重新采样, 采用2个厂家的试剂进行HIV-Ag/Ab1+2检测(ELISA), 核酸检测(HIV NAT)采用单检模式, 补充抗-HIV确证试验-免疫印迹试验(WB), 按归队流程检测, 分析检测数据, 确定可以归队的献血者。结果 采用两个厂家的试剂检测HIV-Ag/Ab1+2标本87 654例, 单试剂反应性85例, 经疾病预防控制中心确认均为阴性; 第一轮归队85例献血者电话召回重新采样46例(39例因不在本地或联系不上未能召回), 有1例ELISA双试剂、NAT、WB均阳性, 献血者永久屏蔽, 20例仍为单试剂反应性, 25例解除屏蔽可以参加献血, 归队率54.3%(25/46);第二轮归队召回20例献血者, 仍有16例为单试剂反应性, 4例解除屏蔽可以参加献血, 总归队率63.0%(29/46);29例归队献血者参加献血检测结果均合格。结论 采用ELISA双试剂加NAT单检, 补充WB确认试验对单试剂反应性献血者进行归队检测的流程、方法是安全、可行的; 献血者ELISA筛查试验中使用两个厂家的检测试剂是有必要的; 归队检测可以消除献血者疑虑, 使有献血意愿的献血者继续参加献血。Abstract: Objective To track and test HIV antigen/antibody(HIV-AG/Ab1+2) single-reagent reactive blood donors, and provide evidence for the feasibility of blood donor rejoining the team.Methods From 2022 to 2023, 85 blood donors who were screened due to the single reagent reactivity of HIV-AG /Ab1+2 test were collected, and re-sampled by telephone. The reagents of two manufacturers were used for HIV-AG /Ab1+2 detection(ELISA), and the single test mode was used for nucleic acid detection(HIV NAT). The anti-HIV confirmation test and Western blot test(WB) were supplemented, and the blood donors who could return were determined by analyzing the test data according to the return procedure.Results A total of 87 654 HIV-Ag/Ab1+2 samples were tested with reagents from the two manufacturers, and 85 were reactive with single reagent, which were all negative by Centers for Disease Control and Prevention(CDC). In the first round of return, 85 blood donors were recalled by telephone and 46 were re-sampled(39 cases could not be recalled because they were not in the local area or could not be contacted). One case of ELISA double reagent, NAT and WB were positive, and the blood donors were permanently shielded, 20 cases were still single reagent reactivity, and 25 cases could participate in blood donation after removal of shielding, with a return rate of 54.3%(25/46). In the second round, 20 blood donors were recalled, 16 of them were still single-reagent reactive, and 4 were able to participate in blood donation after being released from screening. The total return rate was 63.0%(29/46). The results of blood donation test of 29 returned blood donors were all qualified.Conclusion It may be safe and feasible to use ELISA double reagent plus NAT single test and WB confirmation test for returning blood donors with single reagent reaction. It is necessary to use two manufacturers' reagents in blood donor ELISA screening test. The return test can eliminate the doubts of blood donors and make those who are willing to donate blood continue to participate in blood donation.
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表 1 献血者HIV-Ag/Ab1+2检测情况及CDC确认情况
例 项目 标本数 双试剂 CDC确认 单试剂(n=85) CDC确认 0.8≤S/CO < 1 1≤S/CO≤4 S/CO>4 试剂一 87 654 10 9 3 25 9 0 试剂二 6 33 9 0 
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表 2 献血者归队检测结果
例 项目 标本数 0.8≤S/CO < 1(n=6) 1≤S/CO≤4(n=34) S/CO>4(n=6) HIV-Ag/Ab1+2 NAT CDC确认 HIV-Ag/Ab1+2 NAT CDC确认 HIV-Ag/Ab1+2 NAT CDC确认 单试剂 双试剂 单试剂 双试剂 单试剂 双试剂 第一轮 46 0 0 0 0 14 1 1 1 6 0 0 0 第二轮 20 0 0 0 0 10 0 0 0 6 0 0 0 再次献血 29 0 0 0 0 0 0 0 0 0 0 0 0
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