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[血液制品相关感染风险的最新情况]

[Update on infectious risks associated with blood products].

作者信息

Traineau Richard, Elghouzzi Marie-Hélène, Bierling Philippe

机构信息

Etablissement français du sang Ile-de-France, hôpital Saint-Louis, 75475 Paris Cedex 10, France.

出版信息

Rev Prat. 2009 Jan 20;59(1):86-9.

Abstract

Many infectious diseases are transmissible by blood transfusion but the overall risk of transfusion transmitted infections is very low through the combination of restrictive donor selection and increasingly sensitive screening. The noninfectious risks (hemolytic transfusion reactions, circulatory overload, transfusion related lung injury) are higher than the current infectious risks. Bacterial contamination of blood components remains the most frequent infectious risk from transfusion but are constantly declining. The estimated residual risk for transfusion transmitted HIV and hepatitis are lower 1/2 600 000 for HIV, 1/6 500 000 for HCV, 1/1 700 000 for HBV. For the future, the concerns are the risks of emerging or reemerging infections transmitted by blood as dengue, Chickungunya, West Nile Virus... Four transfusion transmissions of vCJD have been reported in UK, uncertainties about the incubation periods, the number of infected donors and the lack of sensitive assays for screening blood aggravate concerns about the transfusion transmission risks for vCJD. The ultimate strategy against infectious disease (all but vCJD) could be to develop inactivation methods. Pathogen inactivation have been implemented for plasma, are expected to become available for platelets, but for red blood cells are only in development.

摘要

许多传染病可通过输血传播,但通过严格的献血者筛选和日益灵敏的筛查相结合,输血传播感染的总体风险非常低。非感染性风险(溶血性输血反应、循环超负荷、输血相关肺损伤)高于当前的感染性风险。血液成分的细菌污染仍然是输血最常见的感染性风险,但正在不断下降。估计输血传播HIV和肝炎的残余风险较低,HIV为1/2600000,HCV为1/6500000,HBV为1/1700000。未来,人们担心的是登革热、基孔肯雅热、西尼罗河病毒等通过血液传播的新出现或重新出现的感染风险。英国已报告4例输血传播变异型克雅氏病(vCJD)病例,潜伏期、受感染献血者数量的不确定性以及缺乏灵敏的血液筛查检测方法,加剧了人们对vCJD输血传播风险的担忧。针对传染病(除vCJD外)的最终策略可能是开发灭活方法。病原体灭活已应用于血浆,预计将用于血小板,但红细胞的病原体灭活仅在研发中。

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