Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland.
UCD National Virus Reference Laboratory, University College Dublin, Dublin, Ireland.
Transfusion. 2022 Sep;62(9):1799-1807. doi: 10.1111/trf.17017. Epub 2022 Jul 13.
A risk-based approach to the testing of blood donations for Human T-Lymphotropic Virus (HTLV) should include an assessment of blood donation seroepidemiology. The objectives of the present study were to determine the proportion of HTLV positive units in Irish blood donations, and subsequently, to estimate the current risk of transfusion transmitted HTLV (TT-HTLV).
Over 3 million donations screened between 1996 and 2020, were included in the study (n = 3,666,253). Factors considered in the assessment of TT-HTLV risk included: (I) HTLV seropositivity, (ii) probability of a leucodepletion failure, and (iii) the HTLV testing strategy.
Six HTLV positive donations were detected throughout the study period, all of them in previously unscreened blood donors (0.000164%; n = 6/3,666,253), 3 of whom had donated prior to the introduction of HLTV antibody testing. On average 0.11% of manufactured blood components assessed, failed to satisfy the leucodepletion quality assurance criteria of less than 1 × 10 cells/unit. In using these values to model the risk of TT-HTLV, it was shown that the combination of leucodepletion with either universal screening of all = donors, or selective testing of first-time donors, a possible HTLV transfusion transmitted infection would be prevented every 468-3776 years.
This is the first report on the proportion of HTLV positive in Irish blood donations (1996-2020) and will be used to inform blood donation screening policy in Ireland. Evidence is provided for recommending a selective HTLV donor screening algorithm in Ireland that is accompanied by a robust framework for continued surveillance of leucodepletion failure rate.
对人嗜 T 淋巴细胞病毒（HTLV）进行基于风险的血液检测应包括对献血者血清流行病学的评估。本研究的目的是确定爱尔兰血液捐献者中 HTLV 阳性单位的比例，进而估计目前输血传播 HTLV（TT-HTLV）的风险。
本研究纳入了 1996 年至 2020 年期间筛查的超过 300 万份献血（n=3666253）。在评估 TT-HTLV 风险时考虑了以下因素：（I）HTLV 血清阳性率、（ii）白细胞去除失败的可能性，以及（iii）HTLV 检测策略。
在整个研究期间共发现 6 例 HTLV 阳性献血，均为既往未筛查献血者（0.000164%；n=6/3666253），其中 3 例在 HTLV 抗体检测引入之前就已献血。平均而言，有 0.11%的制成血制品未能满足白细胞去除质量保证标准，即每单位细胞数小于 1×10。通过使用这些值来模拟 TT-HTLV 的风险，结果表明，白细胞去除与对所有献血者进行普遍筛查，或对首次献血者进行选择性筛查相结合，每 468-3776 年可预防一次可能的 HTLV 输血传播感染。
这是爱尔兰血液捐献者中 HTLV 阳性比例的首次报告（1996-2020），并将用于为爱尔兰的献血筛查政策提供信息。本研究为爱尔兰推荐一种选择性 HTLV 献血者筛查算法提供了证据，同时还建立了一个强大的框架来持续监测白细胞去除失败率。
