Department of Blood Bank, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Department of Pediatrics, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Indian J Med Res. 2022 Jun;156(6):750-755. doi: 10.4103/ijmr.IJMR_2504_19.
BACKGROUND & OBJECTIVES: As per national guidelines, prospective blood donors with a history of jaundice of unknown cause are deferred permanently to prevent the transmission of hepatitis B and C. The validity of this guideline was tested by comparing prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice, with that of donors who were found fit.
Blood samples of 212 consecutive donors (male, n=203) deferred due to a history of jaundice were studied for hepatitis B and C by rapid test kits as well as by chemiluminescence (n=115) or ELISA (n=97). Consecutive healthy donors (n=549; male, n=518) were also studied by ELISA (n=266) or chemiluminescence (n=283).
The cumulative prevalence detected by rapid test kit and ELISA/chemiluminescence tests of hepatitis B (n=10) and C (n=2) among donors deferred due to a history of jaundice (n=212) was 5.7 per cent [95% confidence interval (CI): 2.9, 9.9]. The prevalence of reactive results among healthy donors (n=549) by ELISA/chemiluminescence tests was 3.3 per cent (95% CI: 1.9, 5.2), which included hepatitis B (n=15) and hepatitis C (n=3) cases. Compared to healthy donors, the odds of seropositivity among jaundice-deferred donors was 1.7 (95% CI: 0.8, 3.6), P=0.15. For rapid test-negative deferred donors, the odds of seropositivity by ELISA/chemiluminescence declined to 0.4 (0.1, 1.5), P=0.19.
INTERPRETATION & CONCLUSIONS: The prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice of unknown aetiology did not differ significantly from that in healthy donors. The current practice of permanently deferring such donors depletes valuable donor pool. A strategy of rejecting only those donors who are found reactive on pre-donation testing by rapid test needs further validation.
根据国家指南,有不明原因黄疸史的前瞻性献血者应永久延期,以防止乙型肝炎和丙型肝炎的传播。通过比较因黄疸史而被延期的献血者与合格献血者的乙型肝炎和丙型肝炎的患病率,来检验该指南的有效性。
研究了 212 例连续因黄疸史而被延期的献血者(男性,n=203)的血液样本,使用快速检测试剂盒以及化学发光法(n=115)或酶联免疫吸附法(n=97)检测乙型肝炎和丙型肝炎。还使用酶联免疫吸附法(n=266)或化学发光法(n=283)对连续的 549 例健康献血者(男性,n=518)进行了研究。
通过快速检测试剂盒和酶联免疫吸附法/化学发光法检测,在因黄疸史而被延期的 212 例献血者(n=212)中,乙型肝炎(n=10)和丙型肝炎(n=2)的累积患病率分别为 5.7%(95%置信区间:2.9%,9.9%)。健康献血者(n=549)通过酶联免疫吸附法/化学发光法检测的反应性结果的患病率为 3.3%(95%置信区间:1.9%,5.2%),其中包括乙型肝炎(n=15)和丙型肝炎(n=3)病例。与健康献血者相比,黄疸延期献血者的血清阳性率的比值比为 1.7(95%置信区间:0.8,3.6),P=0.15。对于快速检测阴性的延期献血者,通过酶联免疫吸附法/化学发光法检测的血清阳性率的比值比下降至 0.4(0.1,1.5),P=0.19。
有不明病因黄疸史的前瞻性献血者中乙型肝炎和丙型肝炎的患病率与健康献血者无显著差异。目前对这些献血者永久延期的做法使有价值的献血者群体减少。仅拒绝那些在献血前快速检测中呈阳性反应的献血者的策略需要进一步验证。