Zhou Qiaoling, Liu Anqing, Wang Shaoli, Li Jian, He Miao, Chen Limin
Department of Infectious Diseases, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China.
Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China.
Transfus Med. 2023 Apr;33(2):147-158. doi: 10.1111/tme.12935. Epub 2022 Nov 9.
Hepatitis C virus (HCV) can be transmitted by blood transfusion. The aim of this meta-analysis is to estimate the anti-HCV reactive rate and to define the demographic characteristics of blood donors who have potential threats to blood safety in mainland China for nearly 30 years, in order to provide a safe reference for blood transfusion and corresponding guidance for policymakers to increase blood safety.
Literature reporting the anti-HCV screening reactive rate in Chinese blood donors was identified by systematic searching of four electronic databases from 1991 to 2017. The Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines were strictly followed, and data manipulation and statistical analysis were performed by Stata 15.0.
Our results showed that the post-donation anti-HCV reactive rate was 0.53% (95% confidence interval [CI], 0.51%-0.55%) with a significant variation from 1.58% (95% CI, 1.13%-2.03%) before 1998 to 0.51% (95% CI, 0.48%-0.53%) after 1998 when the Blood Donation Law was implemented in China. In addition, anti-HCV screening reactive rate for family or replacement donors was significantly higher than that in individual voluntary blood donors.
Our results indicated that blood centres in China should convert more eligible first-time donors into repeat donors and turn the 'real family or replacement donors' into individual voluntary blood donors to reduce the risk of transfusion-transmitted HCV. In the meantime, large surveys should be carried out among volunteer donors from high-risk populations.
丙型肝炎病毒(HCV)可通过输血传播。本荟萃分析的目的是估计抗-HCV反应率,并确定近30年来中国大陆对血液安全有潜在威胁的献血者的人口统计学特征,以便为输血提供安全参考,并为政策制定者提高血液安全提供相应指导。
通过系统检索1991年至2017年的四个电子数据库,确定报告中国献血者抗-HCV筛查反应率的文献。严格遵循系统评价和荟萃分析的首选报告项目指南,并使用Stata 15.0进行数据处理和统计分析。
我们的结果显示,献血后抗-HCV反应率为0.53%(95%置信区间[CI],0.51%-0.55%),1998年前为1.58%(95%CI,1.13%-2.03%),1998年后中国实施《献血法》时为0.51%(95%CI,0.48%-0.53%),差异有统计学意义。此外,家庭或替代献血者的抗-HCV筛查反应率显著高于个人自愿献血者。
我们的结果表明,中国的血液中心应将更多符合条件的首次献血者转变为重复献血者,并将“真正的家庭或替代献血者”转变为个人自愿献血者,以降低输血传播HCV的风险。同时,应在高危人群的志愿献血者中开展大规模调查。