Shinde S V, Puranik G V
B.Y.L Nair charitable hospital and T. N. Medical college, Mumbai, India ; Haji Ali Doctor's Quarters Haji Ali, Bldg 1, Flat 27, Mahalaxmi, Mumbai, 400 034 India.
Indian J Hematol Blood Transfus. 2007 Dec;23(3-4):99-103. doi: 10.1007/s12288-008-0006-y. Epub 2008 Mar 19.
Blood donors are of voluntary and replacement type. All donors, especially voluntary, are considered as slow risk for seropositive status for Hepatitis B and C, HIV and syphilis. The present study endeavors to screen blood donors-a slow risk group and evaluate the resultant data.
We screened 23,068 donors serologically over 2 years for the above blood transmissible diseases. Serum alanine aminotranferase (ALT) and bilirubin were evaluated as surrogate markers in hepatitis B and C positive donors.
Seroprevalence rates were found to be HIV (1.96 %), syphilis (2.15 %), hepatitis B (1.98 %) and hepatitis C (0.9 %). Majority donors were voluntary (70.37 %) and male (96.2 %). However seroprevalence rates showed no significant difference: voluntary (7.02 %), replacement (6.67 %) male (6.85 %) and female (6.95 %). HCV and HIV showed highest (29.6 %) while HBV and HCV (2.5 %) showed lowest concomitance. Serum ALT and bilirubin were not effective surrogate markers. No demographic or behavioral variable was found as a significant risk factor.
Thus, all donors need adequate privacy, information, counseling and motivation in order to reduce the seropositive rates in donors. Advent of sensitive tests renders surrogate markers redundant.
献血者分为自愿献血者和替代献血者。所有献血者,尤其是自愿献血者,被视为乙肝、丙肝、艾滋病毒和梅毒血清学阳性状态的低风险人群。本研究致力于对献血者这一低风险群体进行筛查并评估所得数据。
我们在两年内对23068名献血者进行了上述血液传播疾病的血清学筛查。对乙肝和丙肝阳性献血者,评估血清丙氨酸转氨酶(ALT)和胆红素作为替代标志物。
发现血清阳性率分别为:艾滋病毒(1.96%)、梅毒(2.15%)、乙肝(1.98%)和丙肝(0.9%)。大多数献血者为自愿献血者(70.37%)且为男性(96.2%)。然而,血清阳性率无显著差异:自愿献血者(7.02%)、替代献血者(6.67%)、男性(6.85%)和女性(6.95%)。丙肝和艾滋病毒的合并感染率最高(29.6%),而乙肝和丙肝的合并感染率最低(2.5%)。血清ALT和胆红素不是有效的替代标志物。未发现人口统计学或行为变量是显著的风险因素。
因此,为了降低献血者的血清学阳性率,所有献血者都需要适当的隐私保护、信息、咨询和激励。敏感检测方法的出现使替代标志物变得多余。