Analysis of HIV infection among voluntary blood donors based on HIV ELISA and nucleic acid detection

Objective: To analyze the epidemiological characteristics of human immunodeficiency virus (HIV) infection among voluntary blood donors and provide a foundation for improving the donor recruitment strategies and developing a more scientific and effective HIV screening strategy.

Methods: HIV testing data from voluntary blood donors in Nanchang, collected from January 2021 to February 2024, were analyzed. According to the serologic and nucleic acid sequence detection mode, two different reagents were used for ELISA detection and NAT detection. The reactive samples were subjected to western blot confirmatory test, and the confirmed positive samples were sent to the provincial CDC for viral load detection.

Results: Among 264,615 voluntary blood donors, 166 cases (0.627‰) were initially reactive: 165 cases detected by ELISA and 1 by NAT. Confirmed positive samples showed 100% positivity for gp160, gp120, and p24, while the p24 detection rate in the HIV indeterminate group was highest at 78.13%. Among the 24 confirmed positive specimens, 21 (87.5%) had a viral load (VL) > 5,000 copies/mL, and 3 (12.5%) had a viral load (VL) < 5,000 copies/mL.

Conclusions: Confirmed HIV-positive donors exhibited varying levels of viral replication. It is necessary to develop more scientific and effective HIV screening strategies and conduct viral load testing for indeterminate cases to retain qualified blood donors while ensuring blood safety.