Vieira Priscilla Cristina Moura, Lamarão Letícia Martins, Amaral Carlos Eduardo de Melo, Corrêa Angelita Silva de Miranda, de Lima Maria Salete Maciel, Barile Katarine Antônia Dos Santos, de Almeida Karine Lisboa Damasceno, Sortica Vinicius de Albuquerque, Kayath André Salim, Burbano Rommel Mario Rodríguez
Laboratory of Nucleic Acid Test (NAT).
Laboratory of Genetics and Molecular Biology, Foundation Center for Hemotherapy and Hematology of Pará (HEMOPA).
Transfusion. 2017 Aug;57(8):1968-1976. doi: 10.1111/trf.14146. Epub 2017 Jun 7.
Nucleic acid test (NAT) blood screening for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) was introduced in northern Brazil in July 2012. There are several Brazilian articles that have evaluated transfusion transmission risks for HIV and HCV. However, to our knowledge, this article is the first to evaluate the impact of HIV and HCV NAT implementation for blood screening in northern Brazil. The aim of this study was to determine the prevalence and incidence rates of HIV and HCV among blood donors and to compare the residual risk of transfusion transmission of these infections, before (2009-2011) and after (2012-2014) NAT implementation.
HIV and HCV prevalence and incidence were calculated based on rates of confirmed positive samples. Residual risk estimates were based on the incidence and window model described previously. Logistic and Poisson regressions were used in the statistical analysis. A p value of not more than 0.05 was considered significant.
HIV and HCV prevalence were 209.9 and 66.3 per 100,000 donations, respectively. Residual risk for HIV and HCV decreased significantly throughout the two study periods, mainly for HCV in which the reduction was one in 169,492 to one in 769,231 donations. For HIV, the decrease was one in 107,527 to one in 769,231 donations. HIV and HCV incidence rates were 21.13 and 3.06 per 100,000 persons/year before NAT and 14.03 and 2.65 per 100,000 persons/year after NAT.
The HIV and HCV NAT implementation significantly increased the transfusion safety in northern Brazil, bringing benefits to recipients due to better quality of blood products produced.
2012年7月，巴西北部引入了用于人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）检测的核酸检测（NAT）血液筛查。有几篇巴西的文章评估了HIV和HCV的输血传播风险。然而，据我们所知，本文是第一篇评估巴西北部实施HIV和HCV核酸检测对血液筛查影响的文章。本研究的目的是确定献血者中HIV和HCV的流行率和发病率，并比较核酸检测实施前（2009 - 2011年）和实施后（2012 - 2014年）这些感染的输血传播残余风险。
根据确诊阳性样本率计算HIV和HCV的流行率和发病率。残余风险估计基于先前描述的发病率和窗口期模型。统计分析采用逻辑回归和泊松回归。p值不超过0.05被认为具有统计学意义。
HIV和HCV的流行率分别为每10万次献血209.9例和66.3例。在两个研究期间，HIV和HCV的残余风险均显著降低，主要是HCV，其降低幅度从每169,492次献血1例降至每769,231次献血1例。对于HIV，降低幅度从每107,527次献血1例降至每769,231次献血1例。核酸检测实施前，HIV和HCV的发病率分别为每10万人/年21.13例和3.06例，实施后分别为每10万人/年14.03例和2.65例。
在巴西北部实施HIV和HCV核酸检测显著提高了输血安全性，由于生产的血液制品质量提高，给受血者带来了益处。
