Farhadi Elham, Gharehbaghian Ahmad, Karimi Gharib, Samiee Shahram, Tavasolli Farzaneh, Salimi Yahya
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, IR Iran.
Hepat Mon. 2011 Nov;11(11):907-12. doi: 10.5812/kowsar.1735143X.778. Epub 2011 Nov 30.
In recent years, the confidential unit exclusion (CUE) option has been used to increase blood safety at blood transfusion centers in several countries. The epidemiologic characteristics of diseases and demographic characteristics of patients vary in different countries; therefore, we investigated whether the CUE option is useful in Iran. In this study, we determined the prevalences of hepatitis B virus (HBV) and hepatitis C virus (HCV) in CUE-positive and CUE-negative units, as well as the efficacy of the CUE option.
The aim of this study was to evaluate the efficacy of the CUE option in reducing the prevalences of HBV and HCV in blood units.
All donors were tested for the HCV antibody (anti-HCV) and hepatitis B surface antigen (HBsAg). Supplemental tests were performed to confirm the presence of viruses in the units that tested positive. In total, 2000 units (1000 CUE-positive units and 1000 CUE-negative units) were tested using the nucleic acid testing (NAT) method. The prevalence of infectious markers was estimated in all demographic subgroups.
The prevalences of HBV and HCV markers were higher in donors who opted for CUE than in those who did not. The CUE option had low sensitivity (21.5%) and positive predictive value (PPV; 20.9%) for the markers. Most of the donors who opted for CUE for the first time were men with low levels of education.
The CUE option has low sensitivity and PPV, and its effectiveness in reducing the transmission of infectious diseases through window-period units is minimal. The CUE process can be continued in Iran because Iran is geographically located in a region where HBV is endemic; however, higher levels of education are necessary to make this process effective.
近年来，一些国家的输血中心采用保密单位排除（CUE）选项来提高血液安全性。不同国家疾病的流行病学特征和患者的人口统计学特征有所不同；因此，我们调查了CUE选项在伊朗是否有用。在本研究中，我们确定了CUE阳性和CUE阴性单位中乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的流行率，以及CUE选项的效果。
本研究的目的是评估CUE选项在降低血液单位中HBV和HCV流行率方面的效果。
对所有献血者进行丙型肝炎病毒抗体（抗-HCV）和乙型肝炎表面抗原（HBsAg）检测。对检测呈阳性的单位进行补充检测以确认病毒的存在。总共使用核酸检测（NAT）方法检测了2000个单位（1000个CUE阳性单位和1000个CUE阴性单位）。估计了所有人口亚组中感染标志物的流行率。
选择CUE的献血者中HBV和HCV标志物的流行率高于未选择的献血者。CUE选项对这些标志物的敏感性较低（21.5%），阳性预测值（PPV；20.9%）也较低。首次选择CUE的大多数献血者是教育程度较低的男性。
CUE选项的敏感性和PPV较低，其在减少通过窗口期单位传播传染病方面的效果微乎其微。由于伊朗地理位置处于HBV流行地区，CUE流程可以在伊朗继续；然而，需要更高的教育水平才能使这一流程有效。
