Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
PLoS One. 2021 Feb 19;16(2):e0246704. doi: 10.1371/journal.pone.0246704. eCollection 2021.
Estimation of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transfusion risk in blood donors is essential for monitoring the safety of the blood supply and the impact of new screening tests. Due to improvements in donor selection and continuing progress in screening assays, residual risk of virus transmission has significantly decreased over the past years. It is not practical and sometimes even not possible to measure residual risk in blood donors directly and mathematical models are used. The aim of this study was to calculate the prevalence, incidence rates of HBV, HCV and HIV infections and analyse evolution of their transmission residual risk from 2004 to 2018 at the National Blood Center of Lithuania.
Data from the archives of the National Blood Center of Lithuania from 2004 to 2018 was retrospectively analysed. The residual risk was calculated for each virus and year by applying the incidence/window-period model suggested by World Health Organization. For the analysis of the residual risk yearly trends a linear regression was used.
A total of 754,755 blood donors and 1,245,568 donations were included in the analysis and represented a 2.06 donations per donor over 15 years. Average residual risk for HBV, HCV and HIV respectively was 570.04, 807.14 and 35.72 per 1,00,000 donations. During the study period, there was statistically significant downward trend in the residual risk for every analysed virus.
Residual risk of virus transmission has been steadily decreasing over past 15 years in Lithuanian donors, but the current risk remains quite high. It is difficult to establish how much the risk is affected by statistical assumptions or virus prevalence in general population. However, results of this study indicate the need of the population screening program of transfusion transmitted viruses.
估计献血者中的乙型肝炎病毒 (HBV)、丙型肝炎病毒 (HCV) 和人类免疫缺陷病毒 (HIV) 的输血风险对于监测血液供应的安全性和新筛选检测的影响至关重要。由于献血者选择的改进和筛选检测的持续进展，过去几年病毒传播的残余风险显著降低。直接测量献血者的残余风险不切实际，有时甚至不可能，因此使用数学模型。本研究的目的是计算 2004 年至 2018 年期间立陶宛国家血液中心 HBV、HCV 和 HIV 感染的流行率、发病率，并分析其传播残余风险的演变。
对 2004 年至 2018 年立陶宛国家血液中心档案中的数据进行回顾性分析。应用世界卫生组织建议的发病率/窗口期模型计算每种病毒和每年的残余风险。为分析残余风险的年度趋势，使用线性回归。
共纳入 754755 名献血者和 1245568 份献血，15 年间每名献血者平均献血 2.06 份。HBV、HCV 和 HIV 的平均残余风险分别为每 10 万份 570.04、807.14 和 35.72。在研究期间，每种分析病毒的残余风险均呈统计学显著下降趋势。
在过去 15 年中，立陶宛献血者的病毒传播残余风险稳步下降，但目前的风险仍然相当高。很难确定风险在多大程度上受到统计假设或一般人群中病毒流行率的影响。然而，本研究结果表明需要开展人群筛查计划以检测输血传播的病毒。
