Burnet Institute, Melbourne, Vic., Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
Vox Sang. 2020 Apr;115(3):162-170. doi: 10.1111/vox.12891. Epub 2020 Feb 5.
Until recently, people in Australia with a history of injection drug use (IDU) were deferred indefinitely from donating blood. Knowledge gaps regarding policy non-compliance and the prevalence of blood donation practices amongst people who inject drugs (PWID) precluded changes to this policy. We sought to address these gaps and to estimate the additional risk to Australia's blood supply associated with changing the indefinite deferral policy to 1 or 5 years since last injecting episode.
Data on blood donation amongst PWID were collected from 1853 interviews across two Australian studies of PWID conducted during 2015/16. Mathematical modelling was used to estimate the additional risk of hepatitis C (HCV)-infected window period collections as a result of changing the deferral policy.
A very few (2-4%) study participants reported ever donating blood after ≥1 IDU episode. Changing the deferral policy from indefinite to 1 or 5 years was estimated to result in an additional 0·00000070 (95%CI: 0·00000033-0·00000165) or 0·00000020 (95%CI: 0·00000008-0·00000041) HCV-positive window period collections per year, respectively.
Changing Australia's indefinite deferral period to 1 or 5 years since last injecting episode poses a negligible increase in the risk of HCV-infected window period collections from blood donors with a history of IDU. Our results informed a successful submission to the Australian regulator to change the deferral period from indefinite to 5 years since last injecting episode, a policy which came into effect in September 2018.
直到最近,在澳大利亚有注射吸毒史(IDU)的人无限期地被禁止献血。由于对政策不遵守的知识空白以及注射吸毒者(PWID)的献血行为的流行情况缺乏了解,这一政策无法得到改变。我们试图填补这些空白,并估计改变无限期延期政策为最后一次注射后 1 年或 5 年,对澳大利亚血液供应带来的额外风险。
在 2015/16 年期间进行的两项澳大利亚 PWID 研究的 1853 次访谈中收集了 PWID 献血的数据。使用数学模型来估计由于改变延期政策,丙型肝炎(HCV)感染窗口期采血的额外风险。
极少数(2-4%)研究参与者报告在有≥1 次 IDU 史后曾献血。将延期政策从无限期改为 1 年或 5 年,估计每年将导致额外的 0·00000070(95%CI:0·00000033-0·00000165)或 0·00000020(95%CI:0·00000008-0·00000041)例 HCV 阳性窗口期采血。
将澳大利亚的无限期延期政策改为最后一次注射后 1 年或 5 年,从有 IDU 史的献血者中,HCV 感染窗口期采血的风险略有增加。我们的研究结果为成功提交给澳大利亚监管机构,将延期政策从无限期改为最后一次注射后 5 年提供了依据,该政策于 2018 年 9 月生效。