Correll P K, Law M G, Seed C R, Gust A, Buring M, Dax E M, Keller A J, Kaldor J M
National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.
Vox Sang. 2001 Jul;81(1):6-11. doi: 10.1046/j.1423-0410.2001.00056.x.
In Australia, a policy of deferring donors who have lived in the UK for longer than 6 months between 1980 and 1996 has been instituted to reduce the theoretical risk of transmitting variant Creutzfeldt-Jakob disease (vCJD) through the blood supply. The objective of this report was to refine estimates of the possible risks and benefits of donor-deferral strategies that are aimed at avoiding transmission of vCJD.
Estimates of the effect of donor deferral on the blood supply in Australia were based on a 1998 survey of blood donors. The number of donations from donors potentially infected with vCJD and excluded by donor deferral was estimated based on published estimates of the size of the vCJD epidemic in the UK and assuming that the risk of vCJD in Australian blood donors was proportional to the time lived in the UK between 1980 and 1996. The possible increased number of blood donations that were infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV) and made during a window period (as a result of increased donations from first-time donors) was estimated using published methods.
A strategy of deferring donations in Australia from people who have lived in the UK for 6 months or longer, between 1980 and 1996, was estimated to result in exclusion of 5.3% of all blood donations, corresponding to 50 100 donations in 1998. It was estimated that the annual number of blood donations made by donors potentially infected with vCJD is 1.15 (range 0.02--31.1, based on the uncertainty in the UK prevalence estimate). Donor deferral was estimated to remove 0.92 (range 0.02--25.1) of these donations. Replacement of 33%, 50% and 100% of excluded donations by donations from first-time donors, was estimated to result in an increase of 0.0010, 0.0019 and 0.0044, respectively, of HIV-infected donations per year donated during the window period; in an increase of 0.021, 0.038 and 0.089, respectively, of HCV-infected donations per year; and in an increase of 0.18, 0.33 and 0.76, respectively, of HBV-infected donations per year.
The large uncertainties involved in these analyses mean that estimates must be interpreted cautiously, but the data does suggest that donor deferral may exclude more donations from donors potentially infected with vCJD than the corresponding increase, caused by donor replacement, of window-period donations possibly infected with HIV, HCV or HBV.
在澳大利亚，已制定一项政策，推迟1980年至1996年间在英国居住超过6个月的献血者献血，以降低通过血液供应传播变异型克雅氏病（vCJD）的理论风险。本报告的目的是完善旨在避免vCJD传播的献血者推迟策略的潜在风险和益处的估计。
澳大利亚献血者推迟对血液供应影响的估计基于1998年对献血者的调查。根据英国vCJD流行规模的已发表估计，并假设澳大利亚献血者感染vCJD的风险与1980年至1996年间在英国居住的时间成正比，估计了可能感染vCJD并被推迟献血的献血者的献血次数。使用已发表的方法估计了窗口期内（由于首次献血者增加献血）感染人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）或乙型肝炎病毒（HBV）的献血可能增加的数量。
估计在澳大利亚，推迟1980年至1996年间在英国居住6个月或更长时间的人献血的策略将导致排除所有献血的5.3%，相当于1998年的50100次献血。估计每年可能感染vCJD的献血者的献血次数为1.15次（根据英国患病率估计的不确定性，范围为0.02 - 31.1次）。估计推迟献血可排除其中的0.92次（范围为0.02 - 25.1次）。估计用首次献血者的献血分别替代33%、50%和100%被排除的献血，将导致窗口期内每年感染HIV的献血分别增加0.0010次、0.0019次和0.0044次；每年感染HCV的献血分别增加0.021次、0.038次和0.089次；每年感染HBV的献血分别增加0.18次、0.33次和0.76次。
这些分析中涉及的巨大不确定性意味着估计结果必须谨慎解读，但数据确实表明，与因献血者替代导致的窗口期内可能感染HIV、HCV或HBV的献血相应增加相比，推迟献血可能排除更多可能感染vCJD的献血者的献血。
