Estimation of the Residual Risk of Transfusion-Transmissible Infectious Agents in Korea

Abstract

Background: The risk of transfusion-transmissible infections (TTIs) of HBV, HCV, and HIV in Korea has been reduced significantly by strengthening the blood safety policies. On the other hand, the risk of TTI still exists due to the diagnostic window period or viral variants. Methods: The residual risks of TTI of HBV, HCV, and HIV were calculated from July 1, 2012 to June 30, 2018 by dividing the data into two year sets. The residual risk was conducted by separating the donors who donated only once and those who donated more than once during each period. Results: In the first two years, the residual risks of HBV, HCV, and HIV were calculated to be 17.54/10 6 , 0.42/10 6 , and 0.30/10 6 respectively. The residual risk of HBV and HCV over the last two years was calculated to be 9.41/10 6 and 0.27/10 6 , showing a tendency to decrease with time. On the other hand, the residual risk of HIV over the last two years was calculated to be 0.29/10 6 , showing no significant difference. The residual risk in the donors who donated only once was higher than that in the donors who donated more than once during each period. Conclusion: The real transfusion-transmitted infection can be different from the estimated residual risk in this study because this study was based on the thesis that all NAT-reactive blood components cause infection. Because the residual risk of HBV is higher than HCV and HIV, it was considered that the safety measures for the HBV need to be improved continuously.

Transfusion-transmitted infections

“…Therefore, HBV testing was one of the first screening tests introduced in Korea in the 1970s. Although the national vaccination program has led to a gradual decrease in HBV prevalence, the estimated residual risk remains higher than that in Western countries [5,8].…”

“…Furthermore, given the trend to regard HIV as a controllable disease, there is assumed to be no need to conduct an expensive test universally. In Korea, NAT for HIV detection was introduced in 2005 as a screening test for blood donations [5].…”

“…Subsequently, in 2005, the HCV NAT was introduced to further reduce the risk, and is now rapidly spreading to many other countries [11]. In Korea, the residual risk of transfusion-transmitted HCV infection is approximately 0.27 per 10 6 transfusions [5]. A distinctive aspect of blood donor screening in Korea is the alanine transaminase (ALT) test, which is not performed in Western countries [12].…”

Analysis of Results of Donor Blood Screening Tests of Hanmaeum Blood Center (2011~2020)

“…국내에서는 혈액관리법에 따라 혈액선별검사로 에이엘티 (alanine aminotransferase; ALT) 검사, 사람면역결 핍바이러스(HIV), B형간염바이러스(HBV) 그리고 C형간염바이러스(HCV) 등에 대해 혈청학적 및 핵산증폭검사(Nucleic acid testing; NAT)를 시행 하고 있다 [1]. 특히 HIV, HBV, HCV에 대한 혈액 선별검사는 국내외에서 수혈 혈액의 안전성을 크 게 향상시켰다 [2,3].…”