Horowitz B, Prince A M, Hamman J, Watklevicz C
New York Blood Center, NY 10021, USA.
Blood Coagul Fibrinolysis. 1994 Dec;5 Suppl 3:S21-8; discussion S29-S30. doi: 10.1097/00001721-199412003-00006.
Laboratory research that began in 1982 led to the licensing in the USA of a solvent/detergent (SD)-treated factor VIII concentrate in 1985. The licence was granted on the basis of several factors. First, studies had demonstrated the inactivation of several marker viruses (vesicular stomatitis virus, Sindbis virus, Sendai virus) and other viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and non-A, non-B hepatitis virus (NANBHV; now known principally to be hepatitis C virus) added to the factor VIII concentrate just before treatment. Secondly, it had been realized that the relevant viruses in transfusion (e.g. HIV, HBV, NANBHV) all had lipid envelopes. Finally, laboratory, preclinical and clinical evidence indicated that factor VIII and other proteins present in the preparation were unaffected by SD treatment. The applicability of the SD method to a wide range of products and preparations, high process recoveries and a growing body of viral safety information linked with the failure of several other virus-inactivation methods to eliminate hepatitis transmission fostered the adoption of SD technology by more than 50 organizations worldwide. SD mixtures are now used in the preparation of a diverse array of products. Numerous laboratory and clinical studies suggest that coagulation-factor concentrates and other SD-treated products prepared from plasma pools are now safer than the individual units from which they were derived. Also, a large body of evidence indicates that hepatitis A virus (HAV) is not typically transmitted by blood and blood products.(ABSTRACT TRUNCATED AT 250 WORDS)
始于1982年的实验室研究,促使一种经溶剂/去污剂(SD)处理的凝血因子VIII浓缩剂于1985年在美国获得许可。该许可基于多个因素授予。首先,研究表明,在处理前添加到凝血因子VIII浓缩剂中的几种标记病毒(水疱性口炎病毒、辛德毕斯病毒、仙台病毒)以及其他病毒,如人类免疫缺陷病毒(HIV)、乙型肝炎病毒(HBV)和非甲非乙型肝炎病毒(NANBHV;现主要已知为丙型肝炎病毒)均被灭活。其次,人们已经认识到输血中的相关病毒(如HIV、HBV、NANBHV)都有脂质包膜。最后,实验室、临床前和临床证据表明,制剂中存在的凝血因子VIII和其他蛋白质不受SD处理的影响。SD方法对广泛的产品和制剂的适用性、高工艺回收率以及与其他几种病毒灭活方法未能消除肝炎传播相关的越来越多的病毒安全性信息,促使全球50多个组织采用了SD技术。SD混合物现在用于制备各种各样的产品。大量的实验室和临床研究表明,由血浆池制备的凝血因子浓缩剂和其他经SD处理的产品现在比它们所源自的单个单位更安全。此外,大量证据表明甲型肝炎病毒(HAV)通常不会通过血液和血液制品传播。(摘要截于250字)