van den Berg Karin, Murphy Edward L, Pretorius Lelanie, Louw Vernon J
South African National Blood Service, Port Elizabeth, South Africa; Division Clinical Haematology, Department of Internal Medicine, University of the Free State, Bloemfontein, South Africa.
University of California, San Francisco, United States; Blood Systems Research Institute, San Francisco, United States.
Transfus Apher Sci. 2014 Dec;51(3):10-8. doi: 10.1016/j.transci.2014.10.012. Epub 2014 Oct 13.
Cytopaenias, especially anaemia, are common in the HIV-infected population. The causes of HIV related cytopaenias are multi-factorial and often overlapping. In addition, many of the drugs used in the management of HIV-positive individuals are myelosuppresive and can both cause and exacerbate anaemia. Even though blood and blood products are still the cornerstone in the management of severe cytopaenias, how HIV may affect blood utilisation is not well understood. The impact of HIV/AIDS on blood collections has been well documented. As the threat posed by HIV on the safety of the blood supply became clearer, South Africa introduced progressively more stringent donor selection criteria, based on the HIV risk profile of the donor cohort from which the blood collected. The implementation of new testing technology in 2008 which significantly improved the safety of the blood supply enabled the removal of what was perceived by many as a racially based donor risk model. However, this new technology had a significant and sustained impact on the cost of blood and blood products in South Africa. In contrast, it would appear little is known of how HIV influences the utilisation of blood and blood products. Considering the high prevalence of HIV among hospitalised patients and the significant risk for anaemia among this group, there would be an expectation that the transfusion requirements of an HIV-infected patient would be higher than that of an HIV-negative patient. However, very little published data is available on this topic which emphasises the need for further large-scale studies to evaluate the impact of HIV/AIDS on the utilisation of blood and blood products and how the large-scale roll-out of ARV programs may in future play a role in determining the country's blood needs.
血细胞减少，尤其是贫血，在艾滋病毒感染人群中很常见。与艾滋病毒相关的血细胞减少的原因是多因素的，而且常常相互重叠。此外，用于治疗艾滋病毒阳性个体的许多药物具有骨髓抑制作用，可导致并加重贫血。尽管血液和血液制品仍然是治疗严重血细胞减少的基石，但人们对艾滋病毒如何影响血液利用却知之甚少。艾滋病毒/艾滋病对血液采集的影响已有充分记录。随着艾滋病毒对血液供应安全构成的威胁日益明显，南非根据所采集血液的献血者群体的艾滋病毒风险状况，逐步引入了更为严格的献血者选择标准。2008年实施的新检测技术显著提高了血液供应的安全性，使得许多人认为的基于种族的献血者风险模型得以消除。然而，这项新技术对南非血液和血液制品的成本产生了重大且持续的影响。相比之下，人们似乎对艾滋病毒如何影响血液和血液制品的利用知之甚少。考虑到住院患者中艾滋病毒的高流行率以及该群体中贫血的重大风险，预计艾滋病毒感染患者的输血需求会高于艾滋病毒阴性患者。然而，关于这个主题的已发表数据非常少，这突出表明需要进一步开展大规模研究，以评估艾滋病毒/艾滋病对血液和血液制品利用的影响，以及抗逆转录病毒治疗项目的大规模推广未来可能如何在确定该国血液需求方面发挥作用。
