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献血者中B19细小病毒感染的综合分析:意大利的流行病学趋势及其对输血安全和管理策略的影响

Comprehensive analysis of parvovirus B19 infection in blood donors: epidemiological trend and implications for transfusion safety and management strategies in Italy.

作者信息

Candura Fabio, Pati Ilaria, De Fulvio Lucia, Massari Maria Simona, Piccinini Vanessa, Pupella Simonetta, Silvioli Giacomo, Bolcato Matteo, Schepisi Monica Sane, La Raja Massimo, Bruni Roberto, Ciccaglione Anna Rita, Pisani Giulio, Cannata Livia, Donadio Raffaele, Prati Daniele, De Angelis Vincenzo

机构信息

National Blood Centre, Istituto Superiore di Sanità, Rome, Italy.

Department of Medicine, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.

出版信息

Blood Transfus. 2025 Mar;23(2):168-175. doi: 10.2450/BloodTransfus.894. Epub 2024 Dec 16.

Abstract

Parvovirus B19 (B19V) presents a significant concern in the context of blood transfusion safety, given its potential for transmission through contaminated blood products, and the increased viral circulation recently reported across Europe. This study examines the recent epidemiological trends of B19V in Italy, where a notable increase in B19V-positive plasma units was observed during early 2024. While routine NAT testing for B19V in individual blood donations is not currently justified, the existing screening protocols for plasma intended for industrial fractionation are crucial to ensure the safety of plasma-derived medicinal products. However, this situation requires careful consideration of the optimal management of viremic donors and the implementation of targeted look back procedures to trace and monitor recipients of labile blood components. To address these issues, we propose an algorithm for managing both donors and recipients in cases of B19V positivity. These measures aim to balance recipient safety with minimising donor loss, while also addressing significant operational and ethical considerations within blood establishments.

摘要

鉴于细小病毒B19(B19V)有可能通过受污染的血液制品传播,且近期欧洲各地报告其病毒传播有所增加,因此它在输血安全方面是一个重大问题。本研究调查了意大利B19V的近期流行病学趋势,2024年初在该国观察到B19V阳性血浆单位显著增加。虽然目前对个体献血进行B19V的常规核酸检测尚无必要,但现有的用于工业分馏的血浆筛查方案对于确保血浆衍生药物产品的安全至关重要。然而,这种情况需要仔细考虑病毒血症献血者的最佳管理方式以及实施有针对性的追溯程序,以追踪和监测不稳定血液成分的接受者。为解决这些问题,我们提出了一种在B19V呈阳性情况下管理献血者和接受者的算法。这些措施旨在平衡接受者的安全与尽量减少献血者流失,同时也解决血液机构内重大的操作和伦理问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ce/11925254/f55520816c91/BLT-23-168_g001.jpg

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