Transfusion‐transmitted diseases: risks, prevention and perspectives

Abstract

During the past decades major improvements in blood safety have been achieved, both in developed and developing countries. The introduction of donor counseling and screening for different pathogens has made blood a very safe product, especially in developed countries. However, even in these countries, there is still a residual risk for the transmission of several pathogens. For viruses such as the human immunodeficiency virus (HIV), and the hepatitis viruses B and C, this is due mainly to window‐period donations. Furthermore, the threat of newly emerging pathogens which can affect blood safety is always present. For example, the implications of the agent causing new variant Creutzfeld‐Jakob disease for transfusion practice are not yet clear. Finally, there are several pathogens, e.g. CMV and parvo B19, which are common in the general donor population, and might pose a serious threat in selected groups of immunosuppressed patients. In the future, further improvements in blood safety are expected from the introduction of polymerase chain reaction for testing and from the implementation of photochemical decontamination for cellular blood products. The situation in transfusion medicine in the developing world is much less favorable, due mainly to a higher incidence and prevalence of infectious diseases.

Evolution of Blood Donation Patterns in a Hospital-based Blood Centre over a Seven-year Period: Implications for Donor Recruitment and Retention

“…The same trend continued in 2007 with 1.2% seropositivity for volunteer donations and 7.8% for replacement donations. This is consistent with published reports regarding seropositivity rates in these two groups (11). In develop-ing countries like Jamaica with limited access to technological advances in testing procedures, the safety of the blood supply may be improved by ending the dependence on replacement donors as the main source of blood products.…”

Detection of EBV, HBV, HCV, HIV-1, HTLV-I and -II, and SMRV in Human and Other Primate Cell Lines

“…As known from experience in the transfusion and transplantation medicine, human cells can harbor a number of different human pathogens and conveyed a potential risk for the recipients to become infected before extensive screenings of the material were accomplished. In particular, human pathogenic viruses like human immunodeficiency virus type 1 (HIV-1), human T-cell leukemia/lymphoma virus type I and II (HTLV-I and -II), and hepatitis viruses, for example, hepatitis B virus (HBV) and hepatitis C virus (HCV), are found in human donor and patient material [1]. Cell lines were usually established from patient material which might similarly be infected with those viruses or perhaps with viruses linked to specific tumors, for example, human herpes virus type 8 (HHV-8) or novel types of papilloma viruses [2].…”

Mechanisms of Vesicular Stomatitis Virus Inactivation by Protoporphyrin IX, Zinc-Protoporphyrin IX, and Mesoporphyrin IX

“…Finally, regardless of the significant reduction of pathogen transmission by blood and derivatives through pathogen screening and donor counseling, the risk, involving the window period of contamination, still persists (48,49). In order to minimize this risk, the development of new approaches of blood disinfection with drugs targeting a broad range of pathogens should be addressed.…”