Reducing the risk of transfusion-transmitted infectious disease markers in blood and blood component donations: Movement from remunerated to voluntary, non-remunerated donations in Lithuania from 2013 to 2020.

Lithuania has a long history of remunerated donations. The first steps towards voluntary, non-remunerated blood and blood component donations started in 2004. Lithuania achieved 99.98% voluntary non-remunerated donations (VNRDs) in 2020. This study aimed to assess the risk of transfusion-transmitted infectious (TTI) disease markers for remunerated donations in comparison with VNRDs in Lithuania from 2013 to 2020. Data were obtained from the Lithuanian Blood Donor Register. The prevalence was calculated as the rate between the number of confirmed positive results for all TTI disease markers (serological anti-HCV, HBsAg, Ag/anti-HIV 1 and 2, and syphilis, and/or HCV, HBV, and HIV-1 NAT) per 100 donations. The relative risk of infectious disease markers for remunerated donations was then estimated. In total, 796310 donations were made. Altogether, 2743 donations were positive for TTI markers as follows: HCV, 1318; HBV, 768; syphilis, 583; and HIV 1 and 2, 74. The prevalence of confirmed TTI markers were 2.86, 0.97, 0.18, and 0.04 per 100 first-time remunerated donations, first-time VNRDs, repeat remunerated donations, and repeat VNRDs, respectively. Remunerated first-time and repeat donations had a statistically higher prevalence of TTI disease markers than VNRDs. First-time and repeat remunerated donations had statistically significantly higher relative risks of confirmed TTI disease markers than VNRD. In conclusion, the risks of TTI disease markers for remunerated first-time and repeat blood and its component donations are significantly higher than those for VNRDs.