【摘要】 目的：分析2016-2024年武汉地区无偿献血人群HBV血清流行特征和变化趋势，为监测血液安全性和评估血液筛查有效性提供数据支撑。方法：选取2016年1月-2024年12月武汉血液中心无偿献血者血液样本共2026372人份，采用2种乙肝表面抗原(HBsAg)酶联免疫吸附(ELISA)试剂检测和1种核酸试剂检测(NAT)。2种HBsAgELISA试剂复检均呈反应性者判定为HBsAg阳性；HBsAgELISA非反应性而HBVNAT反应性判定为NAT阳性。以每10万人次为单位计算HBV血清流行率。收集性别、年龄、婚姻状况等人口学特征和出生队列、献血次数等信息，分析献血人群HBV感染特征和时间变化趋势。采用χ~2检验评估不同特征群体HBV流行率差异，通过线性回归分析HBV流行率的时间变化趋势，应用Logistic回归分析影响HBV感染的危险因素。结果：2016-2024年武汉地区献血人群HBV阳性样本共5237例，总体流行率258.44/10万人次。其中，HBsAg阳性3945例，流行率194.68/10万人次；HBVNAT阳性1292例，流行率63.76/10万人次。HBsAg流行率呈先下降(2016-2021年)后小幅上升(2022-2024年)的趋势，2024年(224.50/10万人次)与2016年(312.90/10万人次)相比下降了28.25%。单因素分析显示，男性献血者(OR=1.490,95%CI:1.400-1.586,P<0.001)和已婚献血者(OR=4.060,95%CI:3.824-4.311,P<0.001)HBV感染风险较高；HBV感染风险随年龄增长而增加，45岁以上人群HBV感染风险最高(OR=8.138,95%CI:7.473-8.862,P<0.001);1992年后出生的献血者(OR=0.336,95%CI:0.314-0.359,P<0.001)、重复献血者(OR=0.094,95%CI:0.085-0.103,P<0.001)、少数民族(OR=0.660,95%CI:0.565-0.772,P<0.001)和AB血型献血者(OR=0.850,95%CI:0.764-0.946,P=0.003)HBV感染风险相对较低。按年龄分层进行趋势分析显示，HBsAg流行率在18-25岁组(β=-0.930,P<0.001)、26-35岁组(β=-0.885,P=0.001)、36-45岁组(β=-0.792,P=0.011)均呈显著下降趋势，而>45岁组随时间变化趋势不显著；各年龄组HBVNAT流行率的时间变化趋势均不显著。此外，未婚和1992年后出生献血者HBsAg流行率均呈显著下降趋势(β=-0.888,P=0.001;β=-0.896,P=0.001)。除未婚及男性献血者外，HBVNAT流行率在其他不同人口学特征群体中均呈显著上升趋势。结论：2016-2024年武汉地区无偿献血人群HBV血清流行率在不同人口学特征群体之间存在显著差异，但整体处于相对较低水平。这得益于乙肝疫苗接种的普及，以及血液安全措施的持续强化。优化献血人群招募策略，将有助于进一步降低经输血传播HBV的风险。更多还原

【Abstract】 Objective:To analyze the seroepidemiological characteristics and trends of hepatitis B virus(HBV)infection among blood donors in Wuhan from 2016 to 2024,providing data support for monitoring blood safety and evaluating the effectiveness of blood screening.Methods:A total of 2 026 372 blood samples from Wuhan Blood Center from January 2016 to December 2024 were analyzed.The blood samples were tested using two enzyme-linked immunosorbent assay(ELISA) kits for hepatitis B surface antigen(HBsAg) and one nucleic acid testing(NAT) kit.Samples with reactive results in both HBsAg ELISA tests were defined as HBsAg-positive,while samples with nonreactive HBsAg but reactive HBV NAT results were defined as NAT-positive.HBV prevalence was calculated per100 000 donations.Demographic characteristics such as age,sex,and marital status,as well as birth cohort and donation frequency were collected,and the characteristics and temporal trends of HBV infection among blood donors were analyzed.The χ~2 test was used to assess differences in HBV prevalence across subgroups.Temporal trends in HBV prevalence were analyzed by linear regression.Risk factors associated with HBV infection were identified using logistic regression.Results:From 2016 to 2024,there were 5 237 HBV-positive cases among blood donors in Wuhan,with an overall prevalence of 258.44 per 100 000 donations.This included 3 945 HBsAg-positive cases(prevalence:194.68 per100 000 donations) and 1 292 NAT-positive cases(prevalence:63.76 per 100 000 donations).HBsAg prevalence initially declined(2016-2021),followed by a slight increase(2022-2024),with the rate of 2024(224.50 per100 000 donations) being 28.25% lower than that in 2016(312.90 per 100 000 donations).Univariate analysis showed that male donors(OR=1.490,95% CI:1.400-1.586,P <0.001) and married donors(OR=4.060,95% CI:3.824-4.311,P <0.001) had a significantly higher risk of HBV infection.The risk of HBV infection increased with age,and the highest risk was observed in donors aged over 45 years(OR=8.138,95% CI:7.473-8.862,P <0.001).Donors born after 1992(OR=0.336,95% CI:0.314-0.359,P <0.001),repeat donors(OR=0.094,95% CI:0.085-0.103,P <0.001),ethnic minority donors(OR=0.660,95% CI:0.565-0.772,P <0.001) and AB blood type donors(OR=0.850,95% CI:0.764-0.946,P=0.003) had a significantly lower risk of HBV infection.Agestratified trend analysis showed a significant decline in HBsAg prevalence in the 18-25 years group(β=-0.930,P <0.001),26-35 years group(β=-0.885,P=0.001),and 36-45 years group(β=-0.792,P=0.011),but no significant temporal trend was found in the group over 45 years old.The trends of HBV NAT prevalence in all age groups were not significant.HBsAg prevalence declined significantly in unmarried donors and those born after 1992(β=-0.888,P=0.001;β=-0.896,P=0.001).Except for unmarried donors and male donors,HBV NAT prevalence showed a significant increasing trend across all other demographic subgroups.Conclusion:From 2016 to 2024,significant differences in HBV prevalence were observed across various demographic groups among blood donors in Wuhan,though the overall prevalence remained relatively low.This is attributed to the widespread administration of hepatitis B vaccination and the continuous strengthening of blood safety measures.Optimizing the recruitment strategy for blood donors will help further reduce the risk of HBV transmission through blood transfusion.更多还原