Pereira Arturo, Sanz Cristina, Tàssies Dolors, Ramírez Begoña
Service of Hemotherapy, Hospital Clinic Villarroel 170, 08036 Barcelona, Spain.
Haematologica. 2002 Apr;87(4):427-33.
Patient-related blood donors contribute to a significant proportion of the blood units collected in hospital-based blood banks. However, there is some concern on the safety of this kind of donation because of the possible existence of incentives for the donor to conceal deferrable risk factors, thus increasing the risk of donation within the window-period of transfusion-transmitted infections. We tested the hypothesis that if patient-related blood donors are less safe than community ones, the former would display both a higher prevalence of viral markers and a predominance of undisclosed risk-factors with low social acceptability.
Comparison of virus reactivity rates against hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV), and the associated risk-factors, between patient-related and community donors who donated whole blood in our center during a five-year period.
During the period under study 72,226 donors gave 149,944 whole blood units, of which 22,888 (15.3%) were provided by patient-related donors. There were 273 confirmed virus-reactive donations (15 anti-HIV, 148 anti-HCV and 110 HBsAg). The adjusted prevalence of virus reactivity was 19 (95% CI: 11-35) times higher in first-time donors than in repeat donors, 3.5 (95% CI: 2.3-4.1) times higher in donors > or = 30 years old than in younger ones, and 2.5 (95% CI: 1.9-3.2) times higher in patient-related donors than in community donors. With regard to deferrable risk-factors not disclosed at the time of donation, there was no significant difference between patient-related and community donors in the frequency of people who denied any risk-factor or who admitted intravenous drug use or high-risk sex. Past household contact with individuals having liver disease was significantly more frequent in patient-related donors than in community ones.
Our results do not support the hypothesis that patient-related donors represent an increased risk of window-period donation because they conceal deferrable risk factors more frequently than community donors.
在医院血库所采集的血液单位中，患者相关献血者占了相当大的比例。然而，由于献血者可能存在隐瞒可延期风险因素的动机，从而增加了在输血传播感染窗口期内献血的风险，人们对这类献血的安全性存在一些担忧。我们检验了这样一个假设：如果患者相关献血者比社区献血者安全性更低，那么前者会表现出更高的病毒标志物流行率以及更多具有低社会接受度的未披露风险因素。
比较在我们中心五年期间捐献全血的患者相关献血者和社区献血者之间针对丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）和人类免疫缺陷病毒（HIV）的病毒反应率以及相关风险因素。
在研究期间，72226名献血者捐献了149944单位全血，其中22888单位（15.3%）由患者相关献血者提供。有273次确认的病毒反应性献血（15次抗HIV、148次抗HCV和110次HBsAg）。初次献血者的病毒反应性调整患病率比重复献血者高19倍（95%可信区间：11 - 35），30岁及以上献血者比年轻献血者高3.5倍（95%可信区间：2.3 - 4.1），患者相关献血者比社区献血者高2.5倍（95%可信区间：1.9 - 3.2）。关于献血时未披露的可延期风险因素，在否认任何风险因素或承认静脉吸毒或高危性行为的人群频率方面，患者相关献血者和社区献血者之间没有显著差异。患者相关献血者中过去与肝病患者有家庭接触的情况比社区献血者更为频繁。
我们的结果不支持以下假设：患者相关献血者代表了窗口期献血风险增加，因为他们比社区献血者更频繁地隐瞒可延期风险因素。
