RÉSUMÉ
Resumen El examen de rutina de los donantes de órganos para detectar la infección por el virus de la inmunodeficiencia humana (HIV) ha hecho que la transmisión del virus mediante el trasplante de órganos sea poco común. Sin embargo, a pesar de las pruebas de detección de rutina, la transmisión del HIV continúa siendo un riesgo del trasplante de órganos ya que, a diferencia de los tejidos, los órganos sólidos no se pueden procesar, desinfectar, ni modificar para inactivar patógenos infecciosos. A continuación, se describe un caso de posible transmisión de HIV por trasplante de órganos de un donante previamente seronegativo a dos de sus receptores.
Abstract Routine screening of organ donors to detect human immunodeficiency virus (HIV) infection has detected the rare transmission of the virus through organ transplantation. However, despite routine screening, HIV transmission remains a risk in organ transplantation since, unlike tissues, solid organs cannot be processed, disinfected, or modified to inactivate infectious pathogens. A case of possible transmission of HIV by organ transplant is described below, from a previously seronegative donor to two recipients.
RÉSUMÉ
【Objective】 To explore the epidemiological characteristics of voluntary blood donors with enzyme-linked immuno-sorbent assay (ELISA) negative and nucleic acid testing (NAT) positive in Hainan from 2012 to 2022, so as to provide reference for developing rational blood screening strategies. 【Methods】 The screening results for transfusion-transmitted disease markers in 1 161 042 blood samples in Hainan from 2012 to 2022 were retrospectively analyzed. All samples have been measured twice by ELISA and once by NAT. Statistical methods were used to analyze the proportion of ELISA negative and NAT positive (ELISA-/NAT+ ) among voluntary blood donors and its relation with factors including gender, age, ethnicity and region. 【Results】 Among the voluntary blood donors in Hainan from 2012 to 2022, the overall proportion of ELISA-/NAT+ was 0.19% (2 151/1 161 042), and the difference was statistically significant (P<0.05). The ELISA-/NAT+ rate in hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA, human immunodeficiency virus (HIV) RNA and non-discriminating reactive (NDR) was 0.10%, 0.000 3%, 0.000 4% and 0.09% respectively. The ELISA-/NAT+ rate of voluntary blood donors varied among different age groups and gradually increased with age (P<0.05). The ELISA-/NAT+ rate of male donors (0.22%, 1 729/795 032) was significantly higher than that of female donors (0.12%, 422/366 010, P<0.05). The ELISA-/NAT+ rate of Han blood donors was significantly lower than that of Li and Miao blood donors (P<0.05). The ELISA-/NAT+ rate was the highest of 0.32% (301/94 046) in the eastern region, followed by 0.30% (341/113 783) in western region, and 0.16% in both southern and northern region, which also presented a significant difference (P<0.05). 【Conclusion】 The ELISA-/NAT+ rate of voluntary blood donors in Hainan fluctuated from 2012 to 2022, which was related to factors such as age, gender, ethnicity and region.
RÉSUMÉ
【Objective】 To explore the distribution of serological markers related to samples whose serological test results were inconsistent with HBV DNA test results among voluntary blood donors in Xi′an. 【Methods】 A total of 71 HBsAg ELISA positive and NAT non-reactive (ELISA+ /NAT-)blood samples were collected from Shaanxi Blood Center from November 1, 2022 to April 30, 2023. The serological markers of hepatitis B were detected by electrochemiluminescence method, and the HBV S region and C region gene fragments were amplified by nested-PCR. 【Results】 The positive rate of nested-PCR in double ELISA+ /NAT- group(n=30) was statistically higher than that of ELISA+ /NAT- group(n=41)(60% vs 24.4%, P<0.05). Donors in double ELISA+ /NAT- group were all first-time blood donors, with the positive rate of anti-HBc in serum of 100%, and the serological pattern was mainly positive for items 1, 4 and 5 items(80%). Among the ELISA+ /NAT- group, 31.7% were repeat blood donors, with the positive rate of anti-HBc in serum of only 19.51%, and the serological patterns were mainly single anti-HBs positive (43.90%) and all negative (36.58%). 【Conclusion】 There are false positives in the test results of ELISA+ /NAT- group, which leads to unnecessary blood discarding. Meanwhile, the samples with negative NAT may have low levels of HBV DNA, which may lead to missed detection. It is suggested that multiple systems and methods should be applied to trace the blood donors who are HBsAg positive and NAT non-reactive, so as to improve the accuracy of HBV screening of blood donors and reduce blood waste.
RÉSUMÉ
【Objective】 To investigate the distribution of ABO and RhD blood groups among voluntary blood donors in Guangzhou, in order to ensure clinical blood safety and better serve blood donors. 【Methods】 Routine ABO and RhD blood group screening tests were carried out among voluntary blood donors from January 2021 to December 2022. The composition ratio of ABO blood group was statistically analyzed. The samples with discrepancy between forward and reverse blood grouping and negative RhD blood group samples were further verified by serological test to analyze the ABO subtypes and the reasons for missed detection. 【Results】 A total of 749 123 blood samples were screened from January 2021 to December 2022, and 513 291 samples were collected after excluding repeat blood donors, with the ABO blood groups as 208 126(40.55%) of O type, 138 859(27.05%) of A type, 130 987(25.52%) of B type and 35 319(6.88%) of AB type. The screening results showed discrepancy between forward and reverse blood grouping in 506 samples, of which 58 were with weak/non-erythrocyte reaction, 16 with erythrocyte reaction, 215 with weak/non-serum reaction, and 217 with serum reaction. Further serological test indicated that 44 samples were ABO subtypes, among which 13 were subtype A, 26 subtype B, 5 subtype AB and 3 B (A) and 14 Bombay-like blood group. The blood group with the highest missed detection rate in repeat blood donors were A3/B3 subtype (68.42%). A total of 128 unexpected antibody positive samples were detected among 513 291 samples A total of 2 277 samples were screened negative for RhD blood type, of which 2 188 were confirmed to be Rh negative (2 188/513 291, 0.43%), 89 were D variants (89/513 291, 0.02%, ) and 30 were detected with unexpected antibodies (30/2 188, 1.37%). 【Conclusion】 The ABO blood group distribution of blood donors in Guangzhou is O>A>B>AB, and the proportion of RhD negative population is 0.43%, slightly highter than 0.3%-0.4% of Han population nationwide. The ABO blood group subtype is dominated by B subtype. The detection rate and missed detection rate of A3/B3 subtypes in routine blood group tests are the highest.
RÉSUMÉ
【Objective】 To analyze the reentry of single reagent reactive voluntary blood donors in our center, in order to provide data support and reference for the recall of single reagent reactive blood donors. 【Methods】 Collect the information of eligible blood donors from the information system of our center from January 2019 to September 2023 were collected, and the reentry were tracked and retrospectively analyzed. The demographic characteristics, active reentry rate, and re-donation rate of eligible blood donors were analyzed, and the differences between qualified reentry rates and factors affecting re-donation were compared using chi-square test. 【Results】 A total of 3 361 blood donors met the reentry criteria, with an active reentry rate of 2.7% (91/3 361) and a qualified reentry rate of 80.21% (73/91). The reentry rate of eligible blood donors showed significant differences in terms of different genders(3.3% vs 2.1%), educational background(3.7% vs 2.3%), blood donation frequency(9.3% vs 4.0% vs 1.3%), testing items(7.7% vs 2.7% vs 1.9% vs 1.3%) and blood donation types(18.1% vs 2.0%) (P<0.05). Difference was noticed in the qualified rate of blood donor reentry among different age groups (61.1% vs 94.4% vs 81.8%) (P<0.05). A total of 126 blood donors donated again, with a total volume of 47 800 mL, a re-donation rate of 49.3% (36/73) and a qualified rate of re-donation of 98.4% (124/126), showing a difference between repeat blood donors and first-time donors (P<0.05). 【Conclusion】 The active reentry rate of single reagent reactive blood donors in our center is relatively low, but the qualified rate of reentry and the re-donation rate are both high. The re-donation is mainly donation of apheresis platelets, and successful reentry blood donors have a strong willingness to donate blood.
RÉSUMÉ
【Objective】 To investigate asymptomatic infection of hepatitis B virus(HBV) among hepatitis B vaccinated donors in Shenzhen, and analyze its serological and molecular characteristics. 【Methods】 The HBsAg ELISA positive blood samples of blood donors born after 1992 were collected. HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were further detected by Roche electrochemiluminescence immunoassay (ECL). BCP/PC and S regions were amplified by Nested-PCRs, HBV DNA quantification were adopted by qPCR simultaneously, and the sequences were also analyzed. 【Results】 A total of 46 632 blood samples of donors(31 612 males and 15 020 females) from December 2020 to January 2022 collected, and 99 samples with HBsAg ELISA positive were screened out. After tested by ECL, Nested-PCRs, and real-time fluorescence PCR, 61 were confirmed HBsAg positive, with the positive rate at 0.13% (61/46 632), including 49 males (0.16%, 49/31 612) and 12 females (0.08%, 12/15 020). The HBsAg positive rate of males was higher than that of females (P<0.05). 50 out of 61 sequences for S region were obtained. By phylogenetic analysis, there were 46 cases of type B (92%, 46/50, 38 males and 8 females), 4 cases of type C (8%, 4/50, 3 males and 1 female). The high frequency mutations observed in S region were N40S (8/46,17.39%), G44E (7/46,15.22%), Q129H/R(6/46,13.04%), Y161F/S(7/46, 15.22%), V179A(4/46,8.70%), S53L(2/4,50%), C69T(2/4,50%) and I126S/T(2/4,50%), including the immune escape mutations Q129R and T/I126A/N/S/T. 【Conclusion】 Hepatitis B vaccination can significantly reduce the positive rate of HBsAg and increase the safety of blood transfusion. The high frequency immune escape mutations have become a potential risk of blood safety, and need to be further explored.
RÉSUMÉ
【Objective】 To analyze the detection characteristics of a novel serum marker, hepatitis B core-associated antigen (HBcrAg), in the HBsAg-/HBV DNA+ blood donors in Wuxi. 【Methods】 A total of 37 previous HBsAg-/HBV DNA+ blood donors were followed up by telephone and their serum was obtained, and the serum of 22 HBsAg-/HBV DNA+ blood donors was detected by electrochemiluminescence and real-time PCR nucleic acid screening as the OBI group for HBcrAg enzyme-linked immunosorbent assay(ELISA). The serum of 20 healthy blood donors who underwent dual ELISA and one nucleic acid testing(NAT) was selected as the healthy control group, and the serum of 20 patients with chronic hepatitis B who were clinically diagnosed by Wuxi Fifth People's Hospital was selected as the experimental CHB group, and HBcrAg ELISA was detected respectively. The correlation analysis between HBcrAg and HBeAb, HBcAb, ALT and HBV DNA in the OBI group was performed. 【Results】 Thirty-seven blood samples were detected by chemiluminescence for HBsAg and NAT, and 22 HBsAg-/HBV DNA+ samples were detected in the OBI group, with a detection rate of 59.46%. The serum HBcrAg expression content (ng/mL) between the OBI group, the healthy control group and the CHB group were (0.92±0.13), (0.47±0.09) and (1.14±0.23), respectively, and the differences were statistically significant (P0.05). 【Conclusion】 The expression of HBcrAg in the OBI group and CHB group was higher than that in the healthy control group, and the serum HBcrAg was not correlated with HBeAb, HBcAb, ALT and HBV DNA to a certain extent. HBcrAg has a good application prospect in screening HBsAg-/HBV DNA+ blood donors.
RÉSUMÉ
【Objective】 To investigate the frequency of platelet antibodies in voluntary blood donors and patients in Zhongshan, Guangdong Province, and to study the specificity and cross-matching of platelet antibodies. 【Methods】 Platelet antibodies of blood donors and patients were screened by solid-phase immunoadsorption (SPIA), rechecked by flow cytometry (FCM), and antibody specificity was identified by PakPlus enzyme immunoassay, and platelet cross-matching was simulated by SPIA. 【Results】 A total of 1 049 blood donor samples and 598 patient samples were tested, with 6 (0.57%) and 49 (8.19%) samples positive for SPIA,respectively(P<0.05); In SPIA positive samples, the positive concordance rate of FCM in blood donors and patients was 100% vs 95%, and that of enzyme immunoassay was 100% vs 88%. Among the initial screening positive samples of blood donors, 5 were anti-HLA Ⅰ antibodies, accounting for 83%, and 1 was anti CD36 antibody, accounting for 17%, with an incidence rate of 0.10%. Among the 14 samples of enzyme immunoassay positive patients, 2 were anti-GP Ⅱb/Ⅲa, 1 was anti-GP Ⅱa/Ⅱa, 8 were anti HLA Ⅰ, and 3 were mixed antibodies (HLA Ⅰ, GP Ⅱb/Ⅲa, GP Ⅰa/Ⅱa). According to the types of antibodies, HLA Ⅰ antibodies were the most common, accounting for 65% (11/17), followed by HPA related anti GP, accounting for 35% (6/17). The majority of patients had a platelet antibody positive typing rate below 30%, accounting for 71.4% (10/14). 【Conclusions】 The positive rate of platelet antibody of patients in Zhongshan area is significantly higher than that of voluntary blood donors, and most of them are anti-HLA Ⅰ and anti-GP, and the incidence of anti-CD36 is extremely low. Therefore, it is necessary to establish a known platelet antigen donor bank, and at the same time, carry out platelet antibody testing and matching of patients, which is helpful to solve the issue of platelet transfusion refractoriness.
RÉSUMÉ
【Objective】 To analyze the situation of regular whole blood donation in Tianjin between 2013 and 2022, in order to provide data support for improving the recruitment and retention measures of regular blood donors and ensuring safe clinical blood supply. 【Methods】 From 2013 to 2022, 185 639 regular whole blood donors in Tianjin were selected as the study group and 1 015 312 other whole blood donors in the same period were selected as the control group. The demographic data, blood collection volume and blood retest screening of blood donors in the two groups were statistically analyzed. 【Results】 The number of regular blood donors and the volume of blood donated in Tianjin increased year by year from 2013 to 2022, with an average annual growth rate of 6.22% and 6.18%, respectively. From 2013 to 2021, the retention rate of regular blood donors increased first and then decreased. The proportion of male blood donors in the study and control groups showed a decreasing trend but the proportion of female donors showed an increasing trend, with the proportion of male donors in the study group higher than that in the control group and the proportion of female donors lower than that in the control group (both P<0.05). In the study group, the majority of blood donors were in the age of 26-35 years old, followed by those of 36-45 years old; in the control group, the majority of blood donors were in the age of 18-25 years old, followed by those of 26-35 years old; the proportion of blood donors in the study group in the age of 18-25 years old was lower than that in the control group, while the proportion of blood donors of other age group was higher than that in the control group, and the difference was statistically significant (P<0.05). The rates of 200 mL and 300 mL blood donations and insufficient blood donations in the study group were lower than those in the control group, while the rate of 400 mL blood donations was higher than that in the control group, and the differences were statistically significant. Among the blood donors in the study group, the proportion of students, civil servants, medical workers, military personnel, teachers and others was lower than that of the control group, while the proportion of the rest occupations was higher in the study group than that of the control group, and the differences were all statistically significant. There was a significant difference in the proportion of regular blood donors among blood donors of different professions. The re-test deferral rates of ALT and anti-TP in the study group showed a decreasing trend followed by an increasing trend, and the re-test deferral rates of HBV, HCV and HIV showed an increasing trend followed by a decreasing trend, and all the re-test deferral rates in the study group were lower than those in the control group, and the differences were statistically significant (P<0.05) . 【Conclusion】 From 2013 to 2022, the situation of regular blood donors in Tianjin has a certain regularity, and there is certain room for growth. Precise recruitment strategies targeting different populations should be adopted to have more regular blood donors.
RÉSUMÉ
【Objective】 To explore the the potential risks of antiretroviral therapy(ART) drugs on blood safety among blood donors in Shenzhen. 【Methods】 High pressure liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used to measure ART drugs concentrations in the plasma of regular blood donors (negative control group, n=86) and anti-HIV positive individuals (experimental group, n=98, detected from approximately 440 000 blood donors during 2019—2023). The baseline plasma concentrations of ART drugs in the negative control group were clarified, and the impact of ART drugs on blood safety was analyzed. 【Results】 The baseline concentrations of ART drugs were not detected in 86 samples of negative control group. Four positive ART drugs samples were detected in 1∶2 pooled plasma samples of 98 anti-HIV positive blood donors plasma in the resolution test. The ART positive rate of anti-HIV positive donors was 4.08%, with tenofovir, lamivudine and efavirenz detected in three blood donors and lamivudine, lopinavir, ritonavir and zidovudine detected in one blood donor. 【Conclusion】 ART drugs were found among anti-HIV positive blood donors in Shenzhen. Additional research is needed to investigate the motivation of these specific donors, so as to ascertain the groups most susceptible to potential risks, and guarantee blood safety.
RÉSUMÉ
【Objective】 To investigate the population data of human immunodeficiency virus (HIV) infections among voluntary blood donors in Guangzhou between 2012 and 2022, and analyze its characteristics and trends, so as to provide valuable data for formulating targeted prevention and ensuring blood safety. 【Methods】 Voluntary blood donors samples from 2012 to 2022 were screened for p24 antigen and anti-HIV by two ELISA diagnostic kits and HIV RNA by nucleic acid test(NAT). The reactive blood samples were sent to the Disease Control and Prevention Center of Guangzhou for anti-HIV confirmatory test by Western blot. The population characteristics of blood donors with confirmed-positive HIV were subsequently analyzed. 【Results】 There were a total of 3 351 596 blood samples from voluntary blood donors in Guangzhou from 2012 to 2022, of which 708 samples were confirmed-positive of anti-HIV, with a total positive rate of 21.12/100 000, showing a decreasing trend (P<0.05). 1) The positive rates of age groups from high to low were 25-34 year old group, 35-44 year old group, 18-24 year old group, and≥45 year old group. The differences among various groups are statistically significant; 2) The anti-HIV positive rate of first-time blood donors (39.23/100 000) was significantly higher than that of repeat blood donors (10.78/100 000) (P<0.05); 3) The anti-HIV positive rate of male blood donors was 30.45/100 000, which was significantly higher than that of female blood donors (3.46/100 000); 4) The anti-HIV positive rate of individual blood donors (32.18/100 000) was higher than that of group blood donors (9.10/100 000) (P<0.05). 【Conclusion】 From 2012 to 2022, the confirmed-positive rate of anti-HIV among voluntary blood donors in Guangzhou showed a downward trend, which was significantly correlated with the implementation of voluntary blood donation and AIDS prevention policies. Young blood donors are of high risk of HIV, and it is necessary to enhance publicity and education on AIDS prevention through multiple channels among young population. Given that the anti-HIV positive rate of first-time blood donors is much higher than that of repeat blood donors, it is recommended to further optimize the health consultation and physical examination process before blood donation, and take multiple measures to screen high-risk behavior groups. Besides, more efforts should be made to promote publicity and education on AIDS prevention among regular blood donors. It is also important to recruit blood donors from low-risk groups and inform the donors about confidential unit exclusion.
RÉSUMÉ
【Objective】 To investigate and analyze the current situation of blood donors’ complaints in Changsha Blood Center, find out the reasons and characteristics of the complaints, aimed at improving the satisfaction of blood donors and the quality of blood donation service. 【Methods】 The healthcare complaint analysis tool (HCAT) was used to encode and statistically analyze the complaints against our center from 2020 to 2022, and then a three-level framework for complaint management classification was constructed. 【Results】 Blood donors had relatively more appeals to the management of primary classification, accounting for 61.77%(126/204). For secondary classification, complaints mainly focused on the working system and process, accounting for 24.02%(49/204), and the problems related to policies and regulations such as free blood use and voluntary blood donation incentive mechanism, accounting for 22.55%(46/204), and the problems related to environment and facilities such as the adjustment of blood donation centers and blood donation time was not announced timely and not updated synchronously on the Baidu map, accounting for 15.2%(31/204). 【Conclusion】 In response to the demands of blood donors, blood centers should optimize the working process and improve the service model of " Internet + voluntary blood donation" and the service awareness of the staff. Further more, the complaint process should be gradually improved to solve the demands of blood donors in time.
RÉSUMÉ
Background: Hepatitis C virus (HCV) genome undergoes high rate of mutation, which results in generation of genetically diverse HCV isolates. There is paucity of data on mutations in the nonstructural 5b (NS5b) gene of circulating HCV and their implications in the Nigerian population. Here, we identified clinically-important mutations in HCV isolates, which may influence response to therapy and disease prognosis. Methodology: HCV RNA was extracted from a total of 301 blood samples collected from 99 symptomatic treatment-naïve hepatitis patients, 125 HIV-infected individuals and 77 asymptomatic blood donors in Ibadan, Nigeria. The RNA was reversetranscribed to complimentary DNA and HCV NS5B gene amplified by nested PCR. The amplified products of 42 HCV were sequenced and sequences were aligned with those from GenBank and HCV databases in MEGA 7.0. Nucleotide sequences were translated to amino acids while substitutions in the amino acids were analyzed with reference to H77 prototype strain of HCV. Results: A total of 10 amino acid polymorphisms were observed from the 42 sequenced NS5B gene, with the major clinically-important amino acid mutations being S15G in 28 (66.7%) participants, T7N (24, 57.1%), G61R (23, 54.8%), S54L (22, 52.4%), G89E (14, 33.3%), T79M (12, 28.6%), and T711 (11, 26.2%). Others were Q67R (7, 16.7%), Q47H (7, 16.7%) and S84F (2, 4.8%). S15G/A/V mutations were more predominant in patients with HIV (76.9%, 10/13) followed by patients with clinical hepatitis (75.0%, 12/16) and blood donors (46.1%, 6/13). Q67R and T71I mutations were not predominant in patients with clinical hepatitis as they were detected in only 31.3% (5/16) and 43.8% (7/16) participants respectively, compared to S15G (75.0%, 12/16), S54L (68.8%, 11/16), G61R/E (68.8%, 11/16) and T7N/S (56.3%, 9/16). There was no statistically significant difference in the distribution of each of the 10 amino acid polymorphisms detected within patients with symptomatic clinical hepatitis (x 2=9.311, p=0.409), HIV-infected patients (x 2=13.431, p=0.1440) and asymptomatic blood donors (x 2=3.775, p=0.9256). Similarly, there was no significant difference in the distribution between the 3 categories of the study participants except for T79M mutation, which was significantly higher in HIV-infected patients (61.5%, 8/13) compared to patients with clinical hepatitis (18.8%, 3/16) and asymptomatic blood donors (7.7%, 1/13) (x 2=10.456, p=0.0054). Conclusion: Mutations in the NS5B gene could be associated with worse prognosis of the disease or antiviral failure due to viral resistance in patients undergoing therapy. The absence of Q47H mutations in majority of the study participants in our study implies that they will not respond well to daprevir and mericitabine. Screening of patients for pre-existing resistant mutations before commencement of therapy and monitoring during and after therapy are recommended.
Sujet(s)
Humains , Mâle , Femelle , Hepacivirus , Infections à VIHRÉSUMÉ
ABSTRACT Background: The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported. Methods/materials: The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMTHVD) and ARV treatment/ART data were reviewed. Results: Among 142 HIV-blood donors, chronic infection predominated (n = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (n = 43),39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure. Discussion: Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.
RÉSUMÉ
SUMMARY BACKGROUND: Routine screening for viral infections at blood donation is important to avoid transfusion-transmitted infections. It also offers an opportunity to detect an asymptomatic infection. OBJECTIVE: To study changes in serology positivity for viral infections (B and C hepatitis, HTLV-1/2, and HIV) at blood donation in a blood bank from Southern Brazil, comparing two periods of 5 years: the period from 2013 to 2017 with the period from 2018 to 2022. In addition, data on the donor fidelity rate during the studied period were sought. METHODS: Retrospective study using data from 2013 to 2022 from a single blood center electronic database from Curitiba, Southern Brazil. RESULTS: A significant drop in positive serology for all studied viruses was observed: highest in HIV (OR=0.39; 95% CI=0.27-0.57) and lowest in total anti HBc (0.56; 95 CI=0.50-0.63). Anti HBc serology became more commonly seen in women in the period of 2018-2022 when compared to men. No changes in the distribution of positive serology according to donors' ages were observed. Loyalty rates had a median of 70%, with the lowest being 60% in 2013, while the highest was 73% in 2018 and 2022. CONCLUSION: A significant reduction in discarded blood bags due to viral serology was observed when the period of 2013-2017 was compared to 2018-2022 on this blood bank; the highest reduction was observed in HIV serology and the lowest in HBc serology, which became more common in women in the second period. High rates of donor fidelity were observed during the period studied.
RÉSUMÉ
ABSTRACT Introduction: Knowledge, Attitude and Practices (KAP) surveys prove beneficial to the transfusion services by providing an insight into the donors and, thus, aiding in mobilizing and retaining voluntary blood donors. We aim to study the knowledge, attitude and practices of donors towards blood donation in a pandemic setting. Methods: A cross-sectional observational study to assess the knowledge, attitude and practices of blood donors was conducted between June to and October 2020. Non-parametric tests (Mann - Whitney U and Kruskal - Wallis) were performed to evaluate the relation of knowledge, attitude and practices overall scores with age group, gender and history of blood donations (first us. repeat). The Chi-Square test/Fisher's Exact test was used to evaluate the differences in the distribution of Knowledge, Attitude and Practices items within the groups. Results: A total of 403 of 2,748 individuals who came for whole blood donation participated in the study. The mean age of the study population was 31.1years (SD ± 8.4 range: 18 - 58), with 75% of the donors donating for the first time. The fear of acquiring COVID-19 infection was perceived as a major reason for the eligible population not to donate. The overall knowledge, attitude and practice score among the donors was satisfactory, being 76.14%, with a significant association with age. The overall positive attitude and practices scores of blood donors were 85.48% and 78.04%, respectively. Conclusion: The KAP scores were satisfactory among the donors. Timely communication of the precautionary measures at blood centers to contain the spread of the COVID-19 infection and effective counseling would help in motivating and retaining blood donors.
Sujet(s)
COVID-19RÉSUMÉ
Introducción: El SARS-CoV-2 ha tenido un impacto negativo y significativo en los sistemas de salud a nivel mundial, lo cual además amenazó el suministro de sangre necesario para las transfusiones clínicas. Objetivo: Describir las causas del rechazo de donantes de sangre durante la pandemia de covid-19. Métodos: Se realizó un estudio observacional, transversal y retrospectivo en una población de donantes que acudió al Banco de Sangre del Hospital Nacional Ramiro Prialé Prialé, de Huancayo, en Perú, de julio del 2020 a igual mes del 2022. Las variables analizadas fueron sexo, grupo sanguíneo ABO, factor Rh y tipos y causas de rechazo. Resultados: Del total de 10 177 donantes de sangre, fueron diferidos y excluidos 3390 (33,3 %); la causa más frecuente de diferimiento fue el hematocrito bajo (18,0 %) y la de exclusión, la positividad por el anticuerpo del núcleo de la hepatitis B (36,8 %). Asimismo, predominó el sexo masculino entre los que fueron rechazados (55,2 %) y se evidenció un incremento de la tendencia politómica en los donantes diferidos (R²=0,2214) y excluidos (R²=0,1178). Conclusiones: La prevalencia de diferimiento y exclusión de donantes de sangre hallada en esta serie fue relativamente alta en comparación con la registrada en otros estudios, lo cual se debió principalmente, en cada caso respectivo, al hematocrito bajo y a la presencia del anticuerpo del núcleo de la hepatitis B.
Introduction: SARS-CoV-2 has had a negative and significant impact on global health systems, threatening the necessary blood supply for clinical transfusions. Objective: To describe the causes of rejection of blood donors during the COVID-19 pandemic. Methods: An observational, cross-sectional and retrospective study was carried out in a population of donors who attended the Blood Bank of Ramiro Prialé Prialé National Hospital, in Huancayo, Peru, from July, 2020 to the same month, 2022. The analyzed variables were sex, the ABO blood group, Rh factor and types and causes of rejection. Results: Of total of 10 177 blood donors, 3390 (33.3%) were differed and excluded; the most frequent cause of differing was the low hematocrit (18.0%) and the most frequent cause of exclusion was antibody to hepatitis B core antigen positivity (36.8%). Likewise, male sex predominated among those who were rejected (55.2%) and an increment of the polytomous tendency was evidenced in differed (R²=0.2214) and excluded donors (R²=0.1178). Conclusions: The prevalence of differing and exclusion in blood donors was relatively high compared to that reported in other studies, which was mainly due, in each respective case, to the low hematocrit and the presence of antibody to hepatitis B core antigen.
RÉSUMÉ
ABSTRACT Introduction: In Brazil, the blood donor screening for hepatitis B virus (HBV) includes laboratory testing for serological (HBsAg and Anti-HBc) and molecular (HBV DNA) markers. This study aims to correlate serology reactive results with HBV DNA detection among blood donors with at least one HBV infection marker detected in a blood bank in northern Brazil. Method: A retrospective search for HBV reactive blood donor data from January 2017 to December 2019 was performed. Serological screening was performed by chemiluminescent microparticle immunoassays Architect HBsAg and Architect Anti-HBc, whereas molecular screening was performed by the HBV nucleic acid test (HBV NAT). Main results: A total of 556 HBsAg reactive results were detected, between positive (47.66%) and inconclusive (52.34%). A total of 3,658 Anti-HBc reactive results were detected, between positive (83.71%) and inconclusive (16.29%). None of the inconclusive results were associated with HBV DNA detection. The HBV DNA detection rates were 47.55% among HBsAg positive samples and 4.08% among Anti-HBc positive samples. The signal-to-cutoff (S/CO) ratio median of HBV NAT positive samples was superior in comparison to HBV NAT negative samples (p < 0.0001). The thresholds found to optimize sensitivity and specificity were 404.15 for Architect HBsAg and 7.77 for Architect Anti-HBc. Three blood donors were in the window period and 1 occult HBV infection case was detected. Conclusion: High S/CO ratios were more predictive of HBV DNA detection. However, a number of HBV NAT positive samples gave low values, while some HBV NAT negative samples showed high values, reaffirming the significance of molecular testing to enhance transfusion safety.
RÉSUMÉ
Doação voluntária de sangue é um ato desafiador, em especial, durante períodos de crise sanitária. O propósito deste estudo transversal foi analisar os conhecimentos, práticas e atitudes dos estudantes de medicina, do ciclo básico ao internato, quanto à doação de sangue durante a pandemia da Covid-19. O trabalho foi realizado entre maio e dezembro de 2021, via Google forms. Para motivo de comparação, a amostra (n=327) foi dividida em do-adores (n=183) e não doadores (n=144) de sangue e utilizado teste qui-quadrado e teste exato de Fisher, sendo considerado estatisticamente significantes perguntas que obtiveram valores com p<0,05. Os resultados indicam que, mesmo sendo a minoria de ambos os grupos, ainda há uma quantidade significativa de estudantes de medicina que apresentam pouco domínio sobre o processo de doação de sangue, além de estarem permeados por medo e desinformação sobre a segurança da coleta. Fatos estes, ainda mais perceptíveis durante o período da pandemia, no qual o percentual de doadores foi de 30,6%. Desta forma, ressalta-se a necessidade de estratégias educacionais criativas e contextualizadas para esclarecer e sensibilizar melhor os jovens para este ato de solidariedade (AU).
Voluntary blood donation is a challenging act, especially during a health crisis. The purpose of this cross-sectional study was to analyze the knowledge, practices, and attitudes of medical students, from the basic cycle to the internship, regarding blood donation during the Covid-19 pandemic. The work was carried out between May and December 2021 via Google Forms. For comparison, the sample (n=327) was divided into blood donors (n=183) and non-donors (n=144). The chi-square and Fisher's exact tests were used, considering statistically significant questions with p<0.05 p-value. The results indicate that, even though they are a minority of both groups, there is still a significant number of medical students who do not know much about the blood donation process and are permeated by fear and misinformation about blood collection safety. These facts were even more noticeable during the pandemic, in which the percentage of donors was 30.6%. In this way, the need for creative and contextualized educational strategies is highlighted to clarify and better sensitize young people to this act of solidarity (AU).
Sujet(s)
Humains , Mâle , Femelle , Adulte , Donneurs de sang , Enseignement médical , Pandémies , COVID-19RÉSUMÉ
ABSTRACT Introduction: To date, 340 antigen-organized 43 blood group systems are recognized, being ABO, Rh, Kell, Duffy, Kidd, MNS and Diego the most clinically relevant. The aim of this study was to assess the distribution of alleles and genotypes of the blood group systems Rh, Kell, Duffy, Kidd, MNS and Diego in 810 blood donors registered in the hemotherapy unit in northwest Rio Grande do Sul, Brazil Methods: We evaluated the genetic variability of blood groups Rh (c.676G>C and c.307C>T), Kell (c.578C>T), Kidd (c.838A>G), Duffy (c.125A>G and c.l-67T>C), Diego (c.2561C>T) and MNS (c.143T>C) in 810 volunteer blood donors of Rio Grande do Sul, southern Brazil. The genetic profiling was performed through allelic discrimination assays using hydrolysis probes (TaqMan®) real-time PCR system. Results: The most frequent blood group genotypes found in our study population were: RHC*Cc (51.5%), RHC*ee (70.1%), FY*A/FY*B (49.3%), GATA -67T/T (93.5%), KEL*2/KEL*2 (93.4%), Jk*A/JK*B (53.2%) and DI*02/DI*02 (95.4%). Some statistical differences were observed on comparing the population of this study with populations from other states in Brazil, mainly with population of Minas Gerais, Bahia and Paraná, which showed some differences from the population of Porto Alegre, which was more similar to those of Santa Catarina and São Paulo Conclusion: The frequency of red blood cell polymorphisms in our study is different from that of blood donors in other regions of Brazil. The results showed the importance of extended genotyping in adequate blood screening and the existence of rare genotypes in Brazilian regular blood donors