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目的了解天津市无偿献血人群中,男男性行为者(MSM)相关的艾滋病病毒(HIV)阳性病例(AHIs)的流行病学特征,用以指导献血者的招募和选择。方法从《艾滋病综合防治信息系统》中,下载天津市各采供血机构2004-2015年上报的《艾滋病病毒抗体检测情况统计报表》和同期天津市在“无偿献血人员检测”中发现并报告的HIV感染者/艾滋病(AIDS)病例的个案信息,进行流行病学指标的统计分析。结果 2004-2015年,天津市各采供血机构共报告MSM AHIs 115例,占全部采供血机构报告的HIV感染者/AIDS病例的60.5%。MSM AHIs病例被报告时的平均年龄为(27.57±7.09)岁,其中20~29岁年龄组所占比例为62.6%;未婚者占73.0%;大专及以上学历者占45.2%,高中或中专占27.8%;外省户籍占73.0%;汉族占98.3%;职业排在前5位的分别为家政和家务及待业(22.6%)、学生(15.7%)、干部职员(13.0%)、工人(12.2%)、商业服务(10.4%)。MSM AHIs病例首次CD4+T淋巴细胞(简称CD4细胞)检测率为93.0%(107/115),首次CD4细胞检测距离HIV抗体经蛋白印迹试验(WB)确证平均需要(102.94±308.3)天,首次CD4细胞检测的平均值为(424.5±229.6)个/μL。结论天津市无偿献血员中,MSM HIV感染“窗口期”对天津市血液安全产生巨大风险,建议应在采供血机构加强对献血者招募前的咨询,并加强艾滋病知识的宣传,同时加强疾病预防控制机构和采供血机构的合作与信息沟通,做好HIV核酸阳性且WB抗体检测不确定供血者的追访工作。
Objective To understand the epidemiological characteristics of MSM-associated HIV-positive cases (AHIs) in non-compensated blood donors in Tianjin and to guide the recruitment and selection of blood donors. Methods From “HIV / AIDS Integrated Prevention and Control Information System”, we downloaded “Statistical Report on HIV Detection” reported by blood collection and supply agencies in Tianjin from 2004 to 2015 and the report titled “Detection of Unremitted Blood Donors” in Tianjin in the same period Case-by-case information on HIV / AIDS cases and conduct statistical analysis of epidemiological indicators. Results From 2004 to 2015, a total of 115 cases of MSM AHIs were reported by blood collection and supply agencies in Tianjin, accounting for 60.5% of all HIV / AIDS cases reported by blood collection and delivery agencies. The average age of MSM AHI cases was (27.57 ± 7.09) years old, of which 62.6% were from 20 to 29 years old, 73.0% were unmarried, 45.2% were college graduates or above, and high school or secondary school Accounted for 27.8%; other provinces accounted for 73.0% of households; Han accounted for 98.3%; occupations in the top 5 were domestic and household and unemployed (22.6%), students (15.7%), cadres and staff (13.0% %), Business services (10.4%). The detection rate of the first CD4 + T lymphocyte (CD4) in MSM AHIs was 93.0% (107/115). The first CD4 cell detection required an average of (102.94 ± 308.3) days from HIV antibody confirmation by Western blot (WB) The average CD4 cell count was (424.5 ± 229.6) cells / μL. Conclusion Among MSM donators in Tianjin, MSM HIV infection “window period ” poses a great risk to blood safety in Tianjin. It is suggested that counseling and counseling before blood donors should be strengthened in blood collection and blood donation agencies, and HIV / AIDS knowledge should be promoted at the same time Disease prevention and control agencies and blood collection and delivery agencies to cooperate and information communication, HIV positive and WB antibody detection uncertain donor follow-up work.