Diekamp U, Kamutzky K, Windel C D
Blutspendedienst der DRK-Landesverbände NSOB, Springe, Deutschland.
Beitr Infusionsther Transfusionsmed. 1997;34:5-10.
561 out of 2,777,021 blood donations from 582,655 donors tested confirmed positive for anti-HCV (RIBA II or Matrix Dot), 549 of them at their first donation, in their first HCV test ever, or in the first HCV test with a new, more sensitive test generation. Thus, our anti-HCV prevalence is 0.037% or 1 in 2,679 donations; among first-time donations it is five times higher than among repeat donations. Twelve repeat donors seroconverted, yielding an anti-HCV incidence of 0.0008% or 1 in 122,570 repeat donations and a seroconversion rate of 2.32 per 10(5) repeat donor person-years. The residual risk associated with transfusion of blood for repeat donors amounts to 5.2 per 10(6) repeat donations. We estimate a risk reduction from introduction of direct virus genome testing after PCR to be at 3.7 per 10(6) repeat donations. Look-backs among recipients of the last seronegative blood products from 12 donors with subsequent seroconversion revealed no recipient infection. Thus, today the residual risk for HCV transmission through transfusion of blood components obtained from Lower Saxony blood donors is quite low. The added safety from direct virus genome testing after PCR is considered extremely low, which casts doubt on the cost-effectiveness of such a measure.
在来自582,655名献血者的2,777,021次献血中，有561次检测出抗丙型肝炎病毒呈阳性（重组免疫印迹试验II型或基质斑点试验），其中549人是在首次献血时、首次进行丙型肝炎病毒检测时，或首次使用新一代更灵敏的检测方法进行丙型肝炎病毒检测时被检测出阳性。因此，我们的抗丙型肝炎病毒流行率为0.037%，即每2,679次献血中有1次呈阳性；在首次献血中，这一比例比重复献血者高出五倍。有12名重复献血者发生了血清转化，抗丙型肝炎病毒发病率为0.0008%，即每122,570次重复献血中有1次发生血清转化，血清转化率为每10⁵名重复献血者人年2.32例。重复献血者输血相关的残余风险为每10⁶次重复献血中有5.2例。我们估计，在聚合酶链反应后引入直接病毒基因组检测可使风险降低至每10⁶次重复献血中有3.7例。对12名随后发生血清转化的献血者最后一次血清阴性血液制品的受血者进行追溯，未发现受血者感染。因此，如今通过下萨克森州献血者的血液成分输血传播丙型肝炎病毒的残余风险相当低。聚合酶链反应后直接病毒基因组检测所增加的安全性被认为极低，这让人怀疑这种措施的成本效益。
