Epidémies chikungunya et zika aux Antilles : bilan des mesures de prévention des risques de transmission par produits sanguins

Mitigating the risk of transfusion‐transmitted infections with vector‐borne agents solely by means of pathogen reduction

“…Documented experience confirmed PRT efficacy and the absence of breakthrough TTIs after transfusion of PRtreated platelets when the A/UVA PRT was used in the French Antilles to secure the blood supply during CHIKV and ZIKV outbreaks; the investigation of post-donation information cases demonstrated the absence of TTIs after transfusion of A/UVA-treated (PR) platelets collected from CHIKV-and ZIKV-infected donors. 49 While up to 10 5 PFU/mL infectious titers of CHIKV were measured in co-components, no TTI was observed in the recipients of PR-platelet components collected from CHIKV RNApositive donors and no remaining CHIKV infectivity was present in aliquots of the transfused PR-platelet components after PRT treatment. 49 Similarly, no TTI was observed in the recipients of PR-platelet components collected from ZIKV RNA-positive donors and no ZIKV infectivity was present in aliquots of the transfused PRplatelet components after PRT treatment.…”

“…While up to 10 5 PFU/mL infectious titers of CHIKV were measured in co‐components, no TTI was observed in the recipients of PR‐platelet components collected from CHIKV RNA‐positive donors and no remaining CHIKV infectivity was present in aliquots of the transfused PR‐platelet components after PRT treatment 49 . Similarly, no TTI was observed in the recipients of PR‐platelet components collected from ZIKV RNA‐positive donors and no ZIKV infectivity was present in aliquots of the transfused PR‐platelet components after PRT treatment 49 …”

“…49 Similarly, no TTI was observed in the recipients of PR-platelet components collected from ZIKV RNA-positive donors and no ZIKV infectivity was present in aliquots of the transfused PRplatelet components after PRT treatment. 49 The findings in this study are promising and should trigger various levels of interest depending on current strategies in place to mitigate the risk of TTIs by vectorborne pathogens in the United States. Of note, TTIs continue to be reported, albeit infrequently, for WNV 10,55,56 and Plasmodium, [57][58][59] as examples, even with the current interventions of donor health histories and/or testing in place.…”

“…47 In all cases, deferrals and testing methodologies alone were insufficient to mitigate TTI-risk-related supply disruption due to prolonged development and regulatory approval timelines; meanwhile, the A/UVA PRT of platelets and plasma helped to enable blood sustainability. 20,24,42,[47][48][49][50][51][52] Most recently, the SARS-CoV-2 pandemic and associated COVID-19 has highlighted concerns about health system infrastructure vulnerability and the potential impact on blood product availability. 53 Donations decreased due to canceled donation appointments and donor deferrals, while blood usage increased with a surge in re-scheduled elective surgeries.…”

“…Several examples have shown how emerging pathogens have disrupted blood availability, including CHIKV, DENV, and ZIKV outbreaks on French Ile de La Réunion, 42 in Guadeloupe and Martinique, 39,43 in French Polynesia, 44 and in the Caribbean region, 45,46 as well as in Italy 47 . In all cases, deferrals and testing methodologies alone were insufficient to mitigate TTI‐risk‐related supply disruption due to prolonged development and regulatory approval timelines; meanwhile, the A/UVA PRT of platelets and plasma helped to enable blood sustainability 20,24,42,47–52 …”