Knödler B, Kühnl P, Lubitz B, Roos D, Becks M, Gutensohn K
Abt. für Transfusionsmedizin und Transplantationsimmunologie, Universitäts-Krankenhaus Eppendorf, Hamburg, BRD.
Beitr Infusionsther. 1992;30:13-6.
With regard to the controversial issue of a reduction of transfusion-associated infections by non-remunerated donations, epidemiological data on the prevalence of HIV-1, HIV-2 and hepatitis C virus (HCV) are of particular interest in our country. We investigated four sample categories: (1) healthy employees and workers from Hamburg; (2) hemodialysis patients; (3) hemato-oncological patients, and (4) blood donors, and tried to differentiate between the three disputed vectors of community-acquired (sexually or pregnancy-transmitted), nosocomial and transfusion/transplantation-associated HCV infections. We conclude from our results that--prior to the implementation of blood screening--our carefully selected 'paid blood donors' conferred no higher HCV risks than the general (working) population (0.66 vs. 0.82% HCV antibody prevalence). Besides transfusions/transplantations, significant nosocomial risks apparently exist in hemodialysis units (21.0 vs. 9.5% HCV seroprevalence in polytransfused patients). Preventive measures, e.g. separate dialysis machines for HCV-positive patients, seem to be advisable.
关于无偿献血能否减少输血相关感染这一颇具争议的问题,我国对于人类免疫缺陷病毒1型(HIV-1)、人类免疫缺陷病毒2型(HIV-2)和丙型肝炎病毒(HCV)流行情况的流行病学数据尤为关注。我们调查了四类样本:(1)汉堡的健康员工和工人;(2)血液透析患者;(3)血液肿瘤患者;(4)献血者,并试图区分社区获得性(性传播或母婴传播)、医院感染以及输血/移植相关丙型肝炎病毒感染这三种有争议的传播途径。我们从研究结果得出结论,在实施血液筛查之前,我们精心挑选的“有偿献血者”感染丙型肝炎病毒的风险并不高于普通(工作)人群(丙型肝炎病毒抗体流行率分别为0.66%和0.82%)。除了输血/移植外,血液透析单位显然存在显著的医院感染风险(多次输血患者中丙型肝炎病毒血清流行率为21.0%,而普通人群为9.5%)。采取如为丙型肝炎病毒阳性患者配备单独透析机等预防措施似乎是明智的。