目标:2016年,法国允许男男性行为者(MSM)献血,如果他们在过去12个月内没有与男性发生性关系。2020年4月,由于没有观察到对血液安全的负面影响,这一限制放宽至4个月。本研究评估了减少这一推迟期对流行病学监测指标的影响。
方法:本研究比较了第二次延迟变化之前(P1)和之后(P2)两个30个月之间的感染监测指标。
结果:总体而言,79例捐赠的人免疫缺陷病毒(HIV)检测呈阳性(P1中49例,P2中30例),322用于丙型肝炎病毒(HCV)(185和137),622为乙型肝炎病毒(HBV)(355和267),1684为梅毒(799和885)。除梅毒:HIV外,P1和P2之间的阳性捐赠率下降(0.07/10,000捐赠与0.04;p>0.5),HCV(0.25vs.0.20;p<0.05),HBV(0.49vs.0.39;p<0.01)和梅毒(1.10vs.1.29;p<0.001)。对于所有三种病毒,输血传播的残余风险没有增加:艾滋病毒(1/7800,000捐赠与1/10,500,000),HCV(1/25,200,000vs.1/47,300,000)和HBV(1/6,400,000vs.1/6,000,000)。
结论:在2020年4月减少MSM的延期期限并未对剩余风险产生负面影响,仍然很低,或者积极的捐赠率,除了梅毒,这需要仔细监测。为了确保平等获得献血,自2022年3月以来,MSM已被允许在与其他献血者相同的条件下献血(即,过去4个月内不超过一个性伴侣)。
OBJECTIVE: In 2016, France allowed men who have sex with men (MSM) to donate blood if they had not had sex with men in the previous 12 months. In April 2020, this restriction was relaxed to 4 months due to the lack of negative impact observed on blood safety. This study assesses the impact of reducing this deferral period on epidemiological surveillance indicators.
METHODS: This study compares infection surveillance indicators between two 30-month periods before (P1) and after (P2) this second deferral change.
RESULTS: Overall, 79 donations tested positive for human immunodeficiency virus (HIV) (49 in P1 and 30 in P2), 322 for hepatitis C virus (HCV) (185 and 137), 622 for hepatitis B virus (HBV) (355 and 267) and 1684 for syphilis (799 and 885). Positive donation rates decreased between P1 and P2, except for syphilis: HIV (0.07/10,000 donations vs. 0.04; p > 0.5), HCV (0.25 vs. 0.20; p < 0.05), HBV (0.49 vs. 0.39; p < 0.01) and syphilis (1.10 vs. 1.29; p < 0.001). For all three viruses, residual risks of transmission by transfusion did not increase: HIV (1/7,800,000 donations vs. 1/10,500,000), HCV (1/25,200,000 vs. 1/47,300,000) and HBV (1/6,400,000 vs. 1/6,000,000).
CONCLUSIONS: Reducing the deferral period for MSM in April 2020 did not negatively impact residual risks, which remained very low, or the rate of positive donations, except for syphilis, which requires careful monitoring. To ensure equal access to blood donation, MSM have been allowed to donate blood under the same conditions as other donors since March 2022 (i.e., no more than one sexual partner in the last 4 months).