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Lok ASF. Hepatitis B: 50 years after the discovery of Australia antigen. J Viral Hepat 2016; 23:5-14. [PMID: 26280668 DOI: 10.1111/jvh.12444] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 07/16/2015] [Indexed: 12/13/2022]
Abstract
It is an honour to be invited to recount the progress in our understanding and management of hepatitis B 50 years after the discovery of Australia antigen (Au Ag). During this half century, we have gone from identifying the causative agent--hepatitis B virus (HBV), understanding its biology and the disease it causes, to having vaccines that can prevent HBV infection and antiviral therapy that can suppress HBV replication and prevent progression of HBV-related liver disease. As a result of the progress, prevalence of HBV infection and morbidity and mortality from chronic HBV infection has declined.
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Affiliation(s)
- A Suk-Fong Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
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Vassallo R, Goldman M, Germain M, Lozano M. Preoperative Autologous Blood Donation: Waning Indications in an Era of Improved Blood Safety. Transfus Med Rev 2015; 29:268-75. [DOI: 10.1016/j.tmrv.2015.04.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
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53
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Kleinman S, Stassinopoulos A. Risks associated with red blood cell transfusions: potential benefits from application of pathogen inactivation. Transfusion 2015; 55:2983-3000. [PMID: 26303806 PMCID: PMC7169855 DOI: 10.1111/trf.13259] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 06/02/2015] [Accepted: 06/22/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Red blood cell (RBC) transfusion risks could be reduced if a robust technology for pathogen inactivation of RBC (PI-RBCs) were to be approved. MATERIALS AND METHODS Estimates of per-unit and per-patient aggregate infectious risks for conventional RBCs were calculated; the latter used patient diagnosis as a determinant of estimated lifetime exposure to RBC units. Existing in vitro data for the two technologies under development for producing PI-RBCs and the status of current clinical trials are reviewed. RESULTS Minimum and maximum per-unit risk were calculated as 0.0003% (1 in 323,000) and 0.12% (1 in 831), respectively. The minimum estimate is for known lower-risk pathogens while the maximal estimate also includes an emerging infectious agent (EIA) and endemic area Babesia risk. Minimum and maximum per-patient lifetime risks by diagnosis grouping were estimated as 1.5 and 3.3%, respectively, for stem cell transplantation (which includes additional risk for cytomegalovirus transmission); 1.2 and 3.7%, respectively, for myelodysplastic syndrome; and 0.2 and 44%, respectively, for hemoglobinopathy. DISCUSSION There is potential for PI technologies to reduce infectious RBC risk and to provide additional benefits (e.g., prevention of transfusion-associated graft-versus-host disease and possible reduction of alloimmunization) due to white blood cell inactivation. PI-RBCs should be viewed in the context of having a fully PI-treated blood supply, enabling a blood safety paradigm shift from reactive to proactive. Providing insurance against new EIAs. Further, when approved, the use of PI for all components may catalyze operational changes in blood donor screening, laboratory testing, and component manufacturing.
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Affiliation(s)
- Steve Kleinman
- University of British Columbia, Victoria, British Columbia, Canada
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54
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Abstract
BACKGROUND The transfusion of blood components plays a significant role as supportive therapy in the treatment of patients with cancer. Although blood transfusions help manage complications arising from either the patient's primary condition or associated with therapeutic intervention, their use introduces a new set of risks; therefore, health care professionals must be aware of the potential morbidity introduced by using blood components and endeavor to optimize outcomes by ordering transfusions only when the benefits outweigh the inherent risks. METHODS This article sought to review the published literature, including the epidemiology of diseases transmissible via transfusion, performance characteristics for assays used for blood donor screening, surveillance activities to detect newly emergent pathogens, and biovigilance activities reported by public health authorities. RESULTS Effective measures have been implemented to significantly decrease the risk of transmissible diseases associated with transfusion. Reports of viral disease transmitted via transfusion have been nearly eliminated, particularly since the introduction of molecular-based detection technology. The transmission of bacteria and parasites still represents a threat to the use of cellular blood components. Transfusion-associated human prion disease has not been reported in the United States. Immune-mediated reactions due to donor-recipient incompatibility remain a challenge. CONCLUSIONS Transmissible agents most commonly associated with risks due to transfusion are no longer a major threat; however, a significant challenge remains with regard to addressing the need for quick response mechanisms to manage emerging pathogens with the potential for rapid spread, either unintentionally (eg, globalization) or intentionally (eg, bioterrorism). The use of technology to reduce pathogens holds promise for further increasing the safety profile of blood transfusion.
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Affiliation(s)
- German F Leparc
- OneBlood, 10100 Dr Martin Luther King Jr Steet North, St Petersburg, FL 33716, USA
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Seroprevalence of transfusion-transmissible infectious agents among volunteer blood donors between 2006 and 2012 in Zhejiang, China. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:401-10. [PMID: 26192780 DOI: 10.2450/2015.0271-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 02/25/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND The high prevalence of hepatitis B and C viruses (HBV and HCV), paralleling the growing epidemic of human immunodeficiency virus (HIV) and Treponema pallidum (TP) infections in the general population, poses a great threat to blood safety in China. This study investigated the prevalence of serological markers for causative agents of transfusion-transmissible infections (TTI), i.e. HBV, HCV, HIV and TP, among volunteer blood donors in five cities/regions of Zhejiang Province, China. MATERIAL AND METHODS We investigated whole blood and apheresis donations collected at the Blood Services in five cities/regions in Zhejiang Province between January 1, 2006 and December 31, 2012. Two rounds of serological testing were performed for HBsAg, anti-HCV, anti-HIV1/2 and anti-TP using different kits. The rates of serological positivity were calculated and further analysis was performed to examine the association between donors' characteristics and seroprevalence. RESULTS Of the 1,615,120 donations, approximately 40% came from first-time donors and 60% from repeat donors. The overall seroprevalence rates of HBV, HCV, HIV and TP were 0.51%, 0.25%, 0.15% and 0.52%, respectively. The overall prevalences of HCV and HIV remained relatively steady, whereas the prevalence of TP increased sharply after 2010. However, the prevalence of TTI agents varied among volunteer blood donors in different cities/regions and demographic groups. DISCUSSION We collected data on the seroprevalence of TTI agents among volunteer blood donors. Although the risk of TTI is low in China compared to that in some developing countries, sensitive screening methods and recruitment of regular donors are still very important for blood safety and availability.
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Stramer SL, Dodd RY, Chiu CY. Advances in testing technology to ensure transfusion safety - NAT and beyond. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/voxs.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- S. L. Stramer
- American Red Cross Biomedical Services; Gaithersburg MD USA
| | - R. Y. Dodd
- Research and Development; American Red Cross Biomedical Services; Rockville MD USA
| | - C. Y. Chiu
- Laboratory Medicine and Medicine/Infectious Diseases; UCSF School of Medicine; San Francisco CA USA
- UCSF-Abbott Viral Diagnostics and Discovery Center; UCSF School of Medicine; San Francisco CA USA
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Mezochow AK, Henry R, Blumberg EA, Kotton CN. Transfusion transmitted infections in solid organ transplantation. Am J Transplant 2015; 15:547-54. [PMID: 25612502 DOI: 10.1111/ajt.13006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/13/2014] [Accepted: 08/28/2014] [Indexed: 01/25/2023]
Abstract
While the risk of infectious disease transmission through blood transfusion has been greatly reduced as a result of improved screening methods, transfusion-transmissible infections remain a concern for transplant recipients, especially those receiving multiple transfusions. Although transfusion and transplant recipients are at risk for similar infections, the current reporting requirements for infections transmitted by transfusions and organ transplantation vary greatly and remain distinctly separate with no communication between reporting systems. This article reviews 23 past reports of transfusion-transmitted infections in organ recipients acquired through transfusions. While cytomegalovirus was a major focus of such reports in the 1980s, more recent reports have focused on West Nile virus transmission. Additionally, this article highlights challenges in determining transfusion-transmitted infection risk in transplant recipients related to the current reporting systems.
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Affiliation(s)
- A K Mezochow
- U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Division of Blood and Tissue Safety and Availability, Washington, DC
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58
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Custer B, Kessler D, Vahidnia F, Leparc G, Krysztof DE, Shaz B, Kamel H, Glynn S, Dodd RY, Stramer SL. Risk factors for retrovirus and hepatitis virus infections in accepted blood donors. Transfusion 2014; 55:1098-107. [PMID: 25470984 DOI: 10.1111/trf.12951] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/13/2014] [Accepted: 10/13/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND Risk factor surveillance among infected blood donors provides information on the effectiveness of eligibility assessment and is critical for reducing risk of transfusion-transmitted infection. STUDY DESIGN AND METHODS American Red Cross, Blood Systems, Inc., New York Blood Center, and OneBlood participated in a case-control study from 2010 to 2013. Donors with serologic and nucleic acid testing (NAT) or NAT-only confirmed human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), or serology-confirmed human T-lymphotropic virus (HTLV) infections (cases) and donors with false-positive results (controls) were interviewed for putative behavioral and demographic risks. Frequencies and adjusted odds ratios (AORs) from multivariable logistic regression analyses for each exposure in cases compared to controls are reported. RESULTS In the study, 196 HIV, 292 HBV, 316 HCV, and 198 HTLV cases, and 1587 controls were interviewed. For HIV, sex with an HIV+ person (AOR, 132; 95% confidence interval [CI], 27-650) and male-male sex (AOR, 62; 95% CI, 27-140) were primary risk factors. For HBV, first-time donor status (AOR, 16; 95% CI, 10-27), sex with an injection drug user (IDU; AOR, 11; 95% CI, 5-28), and black race (AOR, 11; 95% CI, 6-19) were primary. For HCV, IDU (AOR, 42; 95% CI, 13-136), first time (AOR, 18; 95% CI, 10-30), and a family member with hepatitis (AOR, 15; 95% CI, 6-40) were primary. For HTLV, sex with an IDU (AOR, 22; 95% CI, 10-48), 55 years old or more (AOR, 21; 95% CI, 8-52], and first time (AOR, 15; 95% CI, 9-24) were primary. CONCLUSIONS Despite education efforts and risk screening, individuals with deferrable risks still donate; they may fail to understand or ignore or do not believe they have risk. Recipients have potential transfusion-transmitted infection risk because of nondisclosure by donors.
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Affiliation(s)
- Brian Custer
- Blood Systems Research Institute, San Francisco, California.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California
| | | | | | | | - David E Krysztof
- Scientific Support Office, American Red Cross, Gaithersburg, Maryland
| | - Beth Shaz
- New York Blood Center, New York, New York
| | - Hany Kamel
- Blood Systems, Inc., Scottsdale, Arizona
| | - Simone Glynn
- National Heart, Lung and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Roger Y Dodd
- Holland Laboratory, American Red Cross, Rockville, Maryland
| | - Susan L Stramer
- Scientific Support Office, American Red Cross, Gaithersburg, Maryland
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59
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Sensitivity of individual donor nucleic acid testing (NAT) for the detection of hepatitis B infection by studying diluted NAT yield samples. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 13:227-32. [PMID: 25369612 DOI: 10.2450/2014.0048-14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 05/19/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Screening blood donors for the presence of hepatitis B virus surface antigen (HBsAg) has been the backbone of blood safety. However, occult hepatitis B infection (OBI) in donors can be missed when only HBsAg screening is used. Nucleic acid testing (NAT) is capable of detecting OBI among donors. The aim of our study was to analyse the sensitivity of NAT for detecting OBI. MATERIAL AND METHODS The kits used during the study for serology testing were BioRad Monolisa™ HBsAg Ultra (HBsAg screening), Abbott Architect for anti-HBcAg (total) and anti-HBsAg testing, and Vitros® by Ortho Clinical Diagnostics for anti-HBcAg (IgM). Procleix Ultrio was used for individual donor-NAT (ID-NAT) and Abbott m2000 for estimation of HBV DNA. Out of 28,134 HBsAg non-reactive donors, 25 were ID-NAT-reactive. Of these 25 NAT yield samples, 18 were studied further at different dilutions from 1:2 to 1:16. The doubling dilutions were made with HBV non-reactive AB plasma. Undiluted samples were used for all serological tests and for HBV DNA estimation. RESULTS Of the 18 samples studied, nine were NAT-reactive at a dilution of <1:4 and five out of these showed presence of antibody to core antigen (IgG+IgM). Antibody to surface antigen was present in only two of the nine NAT-reactive samples, one with antibody to core antigen and the other without. Six had a viral load in the range from <10 to 38 IU/mL whereas the viral load in the remaining three samples was not determined. Among the other nine samples which were NAT-reactive at dilutions≥1:4, antibody to core antigen (IgG+IgM) was present in seven. DISCUSSION Our study showed that ID-NAT testing along with HBsAg screening could detect most potentially HBV infectious donors (including those with OBI). NAT screening for HBV on diluted samples could compromise blood safety because samples with a low viral load will escape detection.
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60
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Eder AF, Goldman M. Postdonation Information and Blood Component Retrievals: Realigning Blood Center and Hospital Actions Based on Risk Assessment. Transfus Med Rev 2014; 28:226-34. [DOI: 10.1016/j.tmrv.2014.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 01/12/2023]
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61
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Dodd RY. Transfusion-transmitted infections: testing strategies and residual risk. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Y. Dodd
- American Red Cross; Holland Laboratory; Rockville MD USA
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62
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Enjalbert F, Krysztof DE, Candotti D, Allain JP, Stramer SL. Comparison of seven hepatitis B virus (HBV) nucleic acid testing assays in selected samples with discrepant HBV marker results from United States blood donors. Transfusion 2014; 54:2485-95. [DOI: 10.1111/trf.12653] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/03/2014] [Accepted: 02/12/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Florence Enjalbert
- Department of Haematology; University of Cambridge; Cambridge United Kingdom
| | - David E. Krysztof
- Scientific Support Office; American Red Cross; Gaithersburg Maryland
| | - Daniel Candotti
- National Health Service Blood and Transplant; Cambridge United Kingdom
| | - Jean-Pierre Allain
- Department of Haematology; University of Cambridge; Cambridge United Kingdom
| | - Susan L. Stramer
- Scientific Support Office; American Red Cross; Gaithersburg Maryland
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63
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Affiliation(s)
- Rekha Hans
- Department of Transfusion Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Marwaha
- Department of Transfusion Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kiely P, Margaritis AR, Seed CR, Yang H. Hepatitis B virus nucleic acid amplification testing of Australian blood donors highlights the complexity of confirming occult hepatitis B virus infection. Transfusion 2014; 54:2084-91. [PMID: 24650170 DOI: 10.1111/trf.12556] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/26/2013] [Accepted: 12/06/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND We present an analysis of the first 2 years of hepatitis B virus (HBV) nucleic acid testing (NAT) of the Australian donor population. STUDY DESIGN AND METHODS Between July 5, 2010, and July 4, 2012, all blood donations were screened for HBV DNA and hepatitis B surface antigen (HBsAg). Donors who tested HBsAg negative but HBV NAT positive were assessed as occult hepatitis B infections (OBI) if reactive for antibodies to HBV core antigen (anti-HBc). Donors who were anti-HBc reactive but with nonrepeatable or nondiscriminated NAT results were assessed as HBV inconclusive pending follow-up testing. RESULTS During the study period a total of 2,673,521 donations were screened for HBV. Forty-two chronic OBI infections (5.55/100,000 donors) were identified compared to eight acute serologic window period infections (1.06/100,000 donors). Of the 42 OBI cases, 23 (54.8%) were detected the first time they were screened for HBV DNA while 19 (45.2%) gave one or more HBV NAT-nonreactive results before detection. Of 68 donors initially assessed as HBV inconclusive and available for follow-up, 10 later confirmed as OBI cases while 51 were NAT nonreactive but remained anti-HBc reactive and OBI could not be excluded. CONCLUSION This study demonstrated a substantially higher prevalence of OBI compared to acute serologic window period HBV infections in Australian blood donors. Follow-up testing of OBI cases indicates that HBV DNA is often only intermittently detectable in OBI, highlighting the importance of including anti-HBc to optimize the HBV testing algorithm.
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Affiliation(s)
- Philip Kiely
- Australian Red Cross Blood Service, Melbourne, Australia
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65
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Shyamala V. Transfusion transmitted infections in thalassaemics: need for reappraisal of blood screening strategy in India. Transfus Med 2014; 24:79-88. [PMID: 24605952 DOI: 10.1111/tme.12110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 11/19/2013] [Accepted: 02/03/2014] [Indexed: 12/24/2022]
Abstract
The aim of the study was to assess the blood safety in India through prevalence in thalassaemic population. Safety of the blood supply is a subject of great concern for all recipients. This review attempts to assess the relevance and format of tests for viruses in the context of transfusion transmitted infection (TTI) prevalence in India. Serological marker testing for human immunodeficiency virus-1/2 (HIV-1/2), hepatitis C virus (HCV) and hepatitis B virus (HBV) is mandatory in India. Numerous TTI incidents in the repeat recipients supported by results from nucleic acid technology (NAT) testing indicate the deficiencies in blood safety. The β-thalassaemic population (3-17%) in India has been used to reflect on blood safety. The prevalence of HIV-1/2, HCV and HBV in the Indian donor population, the limitations in accessing safe donors, quality of serological tests and the impact on repeat recipients is evaluated. The reports point to prevalence of ˜2% of viral diseases in the blood donor population, and the insufficiency of serology testing resulting in up to 45% TTIs in thalassaemics. The revelation by individual donation (ID) NAT testing, of 1 per 310 units being serology negative-NAT reactive is alarming. Extrapolating the serology negative NAT reactive yields, for an annual blood supply of 7.9 million units, 23,700 units or nearly 100,000 blood components are likely to be infectious. Though the cost for ID-NAT testing is considered unaffordable for a medium development country such as India, the enormity of TTIs will place an unmanageable cost burden on the society.
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Affiliation(s)
- V Shyamala
- Research Diagnostics, Inc., Bengaluru, India
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66
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The risk of transfusion-transmitted viral infections at the Gabonese National Blood Transfusion Centre. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:330-3. [PMID: 24333085 DOI: 10.2450/2013.0144-13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 10/17/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND Blood transfusions carry the risk of transmitting blood-borne infections. In contrast to the situation in the developed world, there is a limited number of studies examining this problem in sub-Saharan Africa. In this study we aimed to calculate the risks of acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection from units of blood issued by the Gabonese Blood Transfusion Centre between 2009 and 2011. MATERIALS AND METHODS All the donations were tested for infectious diseases and the seroconversion incidence rates of HIV, HBV and HCV were calculated. The residual risk of transfusion-associated transmission for each virus was calculated by multiplying the seroconversion rates by the window period expressed in fractions of a year. RESULTS The risks of becoming infected with HIV, HCV, and HBV in subjects receiving units of blood from the Gabonese Blood Transfusion Centre were 64.7, 207.94 and 534.53 per million donations, respectively. CONCLUSIONS This study, which is the first to quantify the true risks of transfusion-transmitted infections in Gabon, reveals and confirms the need to reinforce preventative and screening strategies to improve transfusion safety in sub-Saharan Africa.
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67
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Rosenberg GK, Lattimore S, Brailsford SR, Hewitt PE, Tettmar KI, Kitchen AD, Ijaz S, Tedder RS. Acute hepatitis B in blood donors over a 5-year period in England and North Wales: who is getting infected? Transfusion 2013; 54:1660-5. [DOI: 10.1111/trf.12497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/02/2013] [Accepted: 10/08/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Gillian K. Rosenberg
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Sam Lattimore
- NHS Blood and Transplant/Public Health England Epidemiology Unit; NHS Blood and Transplant; London UK
| | - Susan R. Brailsford
- NHS Blood and Transplant/Public Health England Epidemiology Unit; NHS Blood and Transplant; London UK
- Clinical Transfusion Microbiology; NHS Blood and Transplant; London UK
| | | | - Kate I. Tettmar
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Alan D. Kitchen
- National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant; London UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Richard S. Tedder
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
- Division of Infection and Immunity; University College London; London UK
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68
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Bianco C, Dodd RY. Infectivity of occult hepatitis B from two different points of view. Transfusion 2013; 53:1379-81. [PMID: 23844642 DOI: 10.1111/trf.12295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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