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Soldan K, Davison K, Dow B. Estimates of the frequency of HBV, HCV, and HIV infectious donations entering the blood supply in the United Kingdom, 1996 to 2003

Health Protection Agency Centre for Infections, Colindale, London, United Kingdom.
Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin (Impact Factor: 5.72). 03/2005; 10(2):17-9.
Source: PubMed

ABSTRACT

Several new tests have been recently introduced by the United Kingdom Blood Services to improve safety. The frequency (or risk) of hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV infectious donations entering the UK blood supply during 1996-2003 has been estimated. These years span the introduction of nucleic acid testing (NAT) for HCV, HIV combination antigen and antibody test and NAT for HIV. The frequency of an infectious donation entering the blood supply due to i) the window period, ii) assay failures and iii) human and technical errors in testing and processing, was estimated. The window period risk was estimated using the incidence of infection in donors and the length of the window period for tests in use, with an adjustment for atypical inter-donation intervals in seroconverting donors. The estimated frequency of infectious donations entering the blood supply during 1996-2003 was 1.66, 0.80 and 0.14 per million for HBV, HCV and HIV respectively. HCV NAT resulted in an over 95% fall in the risk of HCV. Current usage of HIV combined antibody-antigen tests and of HIV NAT reduced the estimated risk of HIV by 10%. Since 1996, the risk of transfusion-transmitted HBV, HCV and HIV infection in the UK has been lowered by several improvements to donation testing, although the absolute reduction in risk has been small. Vigilance for errors and the affects of donor selection may be as or more important than further reductions to window periods of tests for improving blood safety with respect to HBV, HCV and HIV.

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    • "This predominance of young donors (students, apprentices, students) could be explained by the fact that the university campus site is less than 1 km from the site of CNTS and that regular briefings of IEC (Information Education Communication) and mobile collection are organized for students and pupils.[16]. In United Kingdoms, it was of 1/469484[17]. In 2012, the RR was ten times lower than that in 2009. "

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    • "Similar risk of 1 : 7,142.857 or 0.14 per million donors was reported for the 1996–2003 period for the whole of Great Britain [45]. HBV incidence based on HBsAg IgM was halved between 1996 and 2008, with the first-time donors comprising most of the cases [46]. "
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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.
    Full-text · Article · Jun 2013
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    • "In several studies conducted in Pakistan and in other countries of the world, prevalence of TTIs appears high among replacement blood donors compared to voluntary donors [6,7]. Prevalence of TTIs is highly uncommon in the developed countries due to a well-developed healthcare and blood transfusion system which follows stringent donor selection criteria, deferral on the basis of high risk behavior and sensitive screening tests [8]. "
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    ABSTRACT: Objective: To determine the prevalence of Hepatitis-B, Hepatitis-C and Human Immunodeficiency infections in replacement blood donors. Materials and Methods: From January 2004 to December 2011, 108,598 apparently healthy donors donated blood at our Blood Bank. Screening was done by Microparticle Enzyme Immuno Assay (MEIA) method on Axsym System (Abbott Diagnostic, USA) and in year 2011 by Chemiluminescent Immunoassay (CIA) method on Architect i2000 (Abbott Diagnostic, USA). From 2010 onward, HIV reactive donors were advised for confirmatory tests and reported back with the results. Results: Of the 108,598 total donors, 108,393 (99.8%) were replacement donors with a mean age of 28.92 (17-55) years. Of this, only 164 (0.15%) were females. Among the replacement donors, 4,906 (4.5%) were found to be reactive for Hepatitis-B, C and Human Immunodeficiency Virus. All the reactive patients, except one, were males. HbsAg was positive in 2,068 (1.90%) and anti-HCV in 2832 (2.61%) donors, while 111 (0.10%) were positive for Human Immunodeficiency Virus. Co-infectivity was observed in 103 (0.09%) cases. The prevalence appeared to be higher in younger age group (17-30 yrs). Only 16.6% cases should be patients returned with results of the confirmatory tests for HIV and were found positive. Conclusion: Hepatitis-B and C sero-prevalence in our series of replacement donors appears high compared to most studies from neighboring countries and relatively low in comparison to earlier studies from Pakistan. Prevalence of HIV, however, appears low and turn out of HIV positive cases for confirmatory tests is low. Conflict of interest:None declared.
    Full-text · Article · Jun 2013 · Turkish Journal of Haematology
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