Surveillance épidémiologique des donneurs de sang homologues et risque résiduel en France entre 2001 et 2003

Institut de veille sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice cedex, France.
Transfusion Clinique et Biologique (Impact Factor: 0.71). 08/2005; 12(3):239-46. DOI: 10.1016/j.tracli.2005.04.032
Source: PubMed


The national surveillance of French blood donors is performed by the Institut de Veille Sanitaire and the National Reference Center for Hepatitis B and C in transfusion in collaboration with the Etablissement Français du Sang and the Army blood center. The main objectives of this surveillance are to evaluate trends in prevalence and incidence rates of blood-borne infections in the blood donor population, to identify routes of contamination and to assess residual risk. This exhaustive surveillance also contributes to evaluate the blood donor selection and the impact of measures taken to prevent infections in the general population. The analyse of the database of all blood donations obtained from 2001 to 2003 has shown that prevalence rates were stable in the study period (0.60 per 10(4) donors for HIV, 8.0 per 10(4) donors for HCV, 1.8 per 10(4) first-time donors for HBs Ag and 0.56 per 10(4) donors for HTLV), The incidence rate of HIV and HBV (1 per 10(5) person-years) was three-times higher than for HCV (0.35 per 10(5) person-years) and eleven times higher than for HTLV (0.09 per 10(5) person-years). At least, the residual risk of transfusion-transmitted viral infections is very low: 1/3,150,000 donations for HIV, 1/10,000,000 donations for HCV and 1/640,000 donations for HBV. The yield of Nucleic Acid Testing (NAT) is limited since only 2 donations for HIV and 3 for HCV which were negative for antibodies were discarded thank to the NAT.

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    • "The HBV residual risk was estimated at 1 : 640.000 for the 1992–2003 period, and the cost-effectiveness of HIV/HCV NAT was thought poor [42] "
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    ABSTRACT: Despite a considerable reduction of the risk of HBV-infected blood donation entering blood supply (residual risk) due to improved screening by HBV NAT in the developed countries, the bulk of the people with HBV living in the developing countries still needs to be screened by serologic tests such as HBsAg and anti-HBc. Many of these countries lack resources for implementing NAT and are likely to remain so in the next decade or longer, thus depending on the HBV residual risk monitoring based on serologic testing and corresponding estimation methods. This paper reviews main HBV residual risk findings worldwide and the methods based on serology used for their calculation with repeat donors, as well as their extension to the first-time donors. Two artificial datasets with high (4.36%) and low (0.48%) HBV prevalence were generated to test the performance of five methods: the original incidence/window-period model based solely on HBsAg, its modification by Soldan in 2003, the Müller-Breitkreutz model, the HBsAg yield model, and its extension to include anti-HBc seroconversions within a year. The last model was closest to the true values of residual risk and had smallest variation of the estimates in both high and low prevalence data. It may be used for residual risk evaluation in relatively small samples, such as regional blood banks data.
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    ABSTRACT: We document in the present study the trends over the sixteen years in HBV and HCV seroprevalence among blood donors in Turkish populations. In this study, serologic test results of whole blood (n = 6.240.130) donors at 22 Red Crescent Centers between 1989 and 2004 were evaluated retrospectively. The overall prevalence was 4.19% for HBsAg and 0.38% for HCV antibody during the study period. The annual prevalence of HBsAg gradually increased from 4.92% in 1989 to 5.23% in 1991 (p=0.001, t=21.00, CI(95), 17237-22490) and gradually decreased from that to 2.10% in 2004 (p=0.001, t=17.27, CI(95), 12869-21342). The seroprevalence of HCV antibody gradually increased from 18 per 10.000 in 1996, to 56 per 10.000 in 1998 (p=0.073, t=3.81, CI(95), 459.62-5721.23), while that decreased to 34 per 10.000 in 2004 (p=0.021, t=7.49, CI(95), 743.98-3980.11). The seroprevalence of hepatitis B and C has decreased markedly between 1989 and 2004 in Turkey. This could be related to the significant increase in the number of volunteer blood donors that increased from 135,779 to 197,815.
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    ABSTRACT: Surveillance of infectious disease markers in the blood donor population is important to recognize trends in prevalence and incidence of relevant infections. These data are essential to calculate the risk of an undetected infectious donation entering the blood supply and to evaluate the potential benefit of new tests shortening the window period, e.g. the introduction of minipool or individual donation nucleic acid amplification technique (NAT). Prevalence and incidence of transfusion-relevant infections are low in the blood donor population in Germany. A careful selection of donors combined with consistent testing of all donations guarantee the very high safety standard of blood transfusions. However, from 1999 to 2003 prevalent HIV infections increased significantly among firsttime donors. Further studies are necessary to investigate the observed trend. The risk of a window period donation in the study period 2002/2003 was estimated to be 1 in 4.6 million for HIV, 1 in 4.2 million for HCV and 1 in 260,000 for HBV. Implementation of HCV NAT testing has markedly improved transfusion safety because of the clear shortening of the window period, whereas the calculated benefit of HIV-1 NAT or HBV NAT is not quite so pronounced.
    No preview · Article · Apr 2006 · Transfusion Medicine and Hemotherapy
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