墨西哥普埃布拉一家三级护理医院血库采用 ID-NAT 进行献血筛查 HIV、HCV 和 HBV 以及由此产生的医源性传播残余风险

Donated Blood Screening for HIV, HCV and HBV by ID-NAT and the Residual Risk of Iatrogenic Transmission in a Tertiary Care Hospital Blood Bank in Puebla, Mexico.

机构信息

Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Atlixco, Puebla 74360, CP, Mexico.

Banco de Sangre, Hospital Especialidades, Unidad Médica de Alta Especialidad, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Puebla 72000, CP, Mexico.

出版信息

Viruses. 2023 Jun 6;15(6):1331. doi: 10.3390/v15061331.

DOI:10.3390/v15061331

PMID:37376630

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10305412/

Abstract

Hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B virus (HBV) can be transmitted by blood transfusion. Most transmission occurs during the acute viremic phase (AVP), before antibody development. To reduce transmission risk, individual donor nucleic acid testing (ID-NAT) is used. In Puebla, Mexico, serological tests and ID-NAT have been applied to screen blood donors and detect individuals in AVP. In the present study, 106,125 blood donors' data in two periods (2012-2015 and 2017-2019) were analyzed. The residual risk (RR) values were calculated considering ID-NAT results. The RR for HIV was 14 in 1 million donations or 1 in 71,428, the RR for HVC was 6.8 in 1 million donations or 1 in 147,058 and, for HBV, it was 156 in 1 million donations, or 1 in 6410. Previously, it was predicted that the transmission RR of these viruses would be reduced in Mexico through better screening with NAT. The use of ID-NAT has, indeed, increased the safety of blood reserves for HIV and HCV. However, more research is needed to determine why the residual risk of HBV did not decrease as much over the study period. ID-NAT is an important complementary tool for blood donor screening that should be implemented.

摘要

丙型肝炎病毒（HCV）、人类免疫缺陷病毒（HIV）和乙型肝炎病毒（HBV）可通过输血传播。大多数传播发生在急性病毒血症期（AVP），即在抗体产生之前。为了降低传播风险，采用个体供者核酸检测（ID-NAT）。在墨西哥普埃布拉，血清学检测和 ID-NAT 已用于筛选献血者并检测 AVP 个体。本研究分析了两个时期（2012-2015 年和 2017-2019 年）的 106125 名献血者的数据。考虑 ID-NAT 结果计算残余风险（RR）值。HIV 的 RR 值为每 100 万次献血 14 次，即 1 比 71428；HCV 的 RR 值为每 100 万次献血 6.8 次，即 1 比 147058；HBV 的 RR 值为每 100 万次献血 156 次，即 1 比 6410。此前，人们曾预测，通过更好的 NAT 筛查，墨西哥这些病毒的传播 RR 将降低。ID-NAT 的使用确实提高了 HIV 和 HCV 血液储备的安全性。然而，需要更多的研究来确定为什么在研究期间，HBV 的剩余风险没有降低那么多。ID-NAT 是献血者筛查的一个重要补充工具，应该实施。