Routine Blood Donor Screening Research Articles

Seroprevalence of Human T-cell Lymphotropic Virus Types I/II Among Blood Donors in a Tertiary Hospital in Oman.

Routine blood donor screening of human T-cell lymphotropic virus (HTLV) has been practiced in Oman since 2017. Limited data exists on HTLV seroprevalence among Omanis. This study aims to determine the seroprevalence of HTLV-I/II among blood donors attending a hospital-based blood bank to assess the need for a universal versus targeted screening. We conducted a retrospective review of blood donors' results attending a hospital blood bank between January 2017 and February 2020. Blood samples were screened for HTLV-I/II antibodies using ARCHITECT i2000SR. Reactive samples underwent further testing by immunoblot assay (MP Diagnostics HTLV Blot 2.4). Age, gender, and nationality were assessed. All components manufactured at the blood bank undergo leukoreduction before storage. A total of 24 469 first-time blood donors were screened for HTLV antibodies. Most participants were male (n = 22 186, 90.7%), and the majority were Omani (n = 22 711, 92.8%). The age range was 18 to 64 years, with a median of 32 years. The seroreactivity rate was 0.2% (43; 95% CI: 0.12-0.23). Confirmatory testing by immunoblot revealed three indeterminate results (7.9%), of which two were Omani and one non-Omani donor, and the remaining 40 seroreactive donors tested negative. Our study revealed zero seroprevalence of confirmed HTLV among blood donors. The continuation of universal screening for first-time donors is a standard of care. With universal leukoreduction at Sultan Qaboos University Hospital and a very low risk of HTLV in Oman's population, the need for screening regular donors can be reconsidered if these findings are confirmed on a larger scale involving other blood banks in Oman.

Prevalence of HIV P24 Antigen; A Sensitive Marker among Seronegative Antibody Blood Donors in Some Hospitals Within Kaduna Metropolis, Nigeria

Detecting and monitoring HIV infection is crucial for effective disease management. The p24 antigen serves as an early viral marker in HIV diagnosis. Despite advancements in diagnosis and monitoring, there is a need for a comprehensive assessment of p24 antigen prevalence in HIV cases. Therefore, this study aims to ascertain the prevalence of p24 antigen among a diverse population of blood donors in Kaduna metropolis. The study recruited 261 blood donors aged between 18 and 55 from various blood bank units in the metropolis. Initial HIV status determination utilized the Immune-Chromatographic Determine® HIV rapid test kit, followed by re-screening with UnigoldRecombigen HIV 1 and 2, boasting 99.70% specificity and 100% sensitivity. HIGHTOP (HIV) ELISA test kit was employed to screen HIV antibodynegative blood donors for HIV p24 antigen. Additionally, demographic factors like gender, residency, age, and marital status were taken into account. Results indicated p24 antigen detection in 9 out of 261 blood samples, yielding a prevalence of 3.5%. Conversely, 252 samples tested negative for the antigen, resulting in a prevalence of 96.5%. The study's findings support the assertion that HIV p24 antigen serves as a sensitive marker, advocating for its integration into routine blood donor screening within Kaduna metropolis to enhance HIV infection detection rates.

Enhancing blood safety: the utility of NS-1 antigen capture ELISA for detecting acute dengue infections among blood donors during peak transmission periods and the potential to curtail dengue spread

Background: Dengue fever is a viral disease transmitted by mosquitoes and affects millions of people worldwide. It can also be transmitted through blood transfusions, particularly during peak transmission periods. Methods: This was a cross sectional study which was conducted over a two-month period (June 2022 to July 2022) at a tertiary hospital blood bank. A total of 180 nonrepetitive serum samples were collected from voluntary blood donors and analyzed using the dengue NS-1 Ag Microlisa ELISA kit. Results: Among the 180 samples two samples tested positive for the dengue virus NS-1 antigen using the NS-1 antigen capture ELISA, indicating a prevalence of acute dengue virus infection among blood donors during the peak transmission period of 1.2% (2/180). Conclusions: The use of NS-1 antigen testing was shown to be useful for dengue virus detection. Routine screening of blood donors for dengue virus is not universally implemented in many countries, partly due to the lack of sensitive and specific screening tests. However, the use of serological tests, such as ELISA for dengue antibodies or NS-1 antigen, can effectively detect dengue virus in blood donors. Interventions made during peak transmission periods can help in curtailing the spread of dengue infections.

Seroepidemiology of Hepatitis E virus among the voluntary blood donors in the coastal region of Karnataka, India

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG antibodies and HEV RNA, respectively. Results: The overall prevalence of HEV IgM antibodies among study population is found to be 1.39%, with a statistically significant difference between males and females (n=20, 1.18% vs. n=7, 3.07 %; p=0.027). The prevalence of HEV IgG antibodies was 11.39%. Exposure to agriculture, animal husbandry, and poor hand hygiene were significant risk factors for HEV IgG reactivity. Conclusions: Given the high prevalence of HEV viral markers in the study population, routine screening of blood donors for risk factors and implementation of serologic testing in endemic areas may be considered.

Seroepidemiology of Hepatitis E virus among the voluntary blood donors in the coastal region of Karnataka, India

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG antibodies and HEV RNA, respectively. Results: The overall prevalence of HEV IgM antibodies among study population is found to be 1.39%, with a statistically significant difference between males and females (n=20, 1.18% vs. n=7, 3.07 %; p=0.027). The prevalence of HEV IgG antibodies was 11.39%. Exposure to agriculture, animal husbandry, and poor hand hygiene were significant risk factors for HEV IgG reactivity. Conclusions: Given the high prevalence of HEV viral markers in the study population, routine screening of blood donors for risk factors and implementation of serologic testing in endemic areas may be considered.

Seroepidemiology of Hepatitis E virus among the voluntary blood donors in the coastal region of Karnataka, India

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandating HEV screening among blood donors is still only marginally convincing. Therefore, the present study was carried out to determine the incidence and prevalence of HEV infection among blood donors in Coastal Karnataka, India. Methods: This cross-sectional study was conducted in a tertiary care hospital in Udupi district of Karnataka, India. A total of 1939 blood donors were randomly selected between June 2020 to June 2022 to participate in the study, where anti-HEV IgM antibody screening was performed using HEV IgM ELISA test kit (DiaPro, Italy). Further, a randomly selected 588 and 1620 pooled donor samples were screened for anti-HEV IgG antibodies and HEV RNA, respectively. Results: The overall prevalence of HEV IgM antibodies among study application is found to be 1.39%, with a statistically significant difference between males and females (n=20, 1.18% vs. n=7, 3.07 %; p=0.027). The prevalence of HEV IgG antibodies was 11.39%. Exposure to agriculture, animal husbandry, and poor hand hygiene were significant risk factors for HEV IgG reactivity. Conclusions: Given the high prevalence of HEV viral markers in the study population, routine screening of blood donors for risk factors and implementation of serologic testing in endemic areas may be considered.

Multicenter evaluation of the new Alinity s anti-HCV II assay for routine hepatitis C virus blood screening

BackgroundAnti-HCV immunoassays remain the primary serologic test for HCV screening among blood donors. Since 1990s, Anti-HCV assays have evolved and those currently available detect infection earlier and have improved sensitivity and specificity compared with older generation assays. The new Alinity s Anti-HCV II assay, with its innovative design, has improved sensitivity, which shall further enhance safety of blood. MethodsAlinity s Anti-HCV II assay was evaluated at 2 blood services (HKRCBTS & SNBTS). The overall sensitivity was evaluated using known positive samples (n = 5 at HKRCBTS; 50 at SNBTS) and 3 seroconversion panels (panel members =14 at each site). A total of 7,532 blood donor samples were tested to determine the clinical specificity. ResultsThe clinical sensitivity of the new assay was found to be 100% at both sites. HCV seroconversion panel detection rates were 57.1% (8/14) and 14.3% (2/14) for the Alinity s Anti-HCV II and Anti-HCV assays respectively, resulting in an improvement in seroconversion sensitivity of 42.8% for the Anti-HCV II assay over the Anti-HCV assay. The specificity of the Anti-HCV II assay was 100% at HKRCBTS, and 99.95% at SNBTS. ConclusionsThe Anti-HCV II assay detected all known positive specimens and was able to detect samples in seroconversion panels earlier compared to the Anti-HCV assay. The assay showed excellent clinical specificity and generated fewer false-reactive results and was found to be suitable for routine blood donor screening.

Global epidemiology of occult hepatitis B virus infections in blood donors, a systematic review and meta-analysis

This study aimed to assess the global prevalence of occult hepatitis B in blood donors. We searched PubMed, Web of Science, Global Index Medicus, and Excerpta Medica Database. Study selection and data extraction were performed by at least two independent investigators. Heterogeneity (I2) was assessed using the χ2 test on the Cochran Q statistic and H parameters. Sources of heterogeneity were explored by subgroup analyses. This study is registered with PROSPERO, number CRD42021252787. We included 82 studies in this meta-analysis. The overall prevalence of OBI was 6.2% (95% CI: 5.4-7.1) in HBsAg negative and anti-HBc positive blood donors. Only sporadic cases of OBI were reported in HBsAg negative and anti-HBc negative blood donors. The overall prevalence of OBI was 0.2% (95% CI: 0.1-0.4) in HBsAg negative blood donors. The prevalence of OBI was generally higher in countries with low-income economic status. The results of this study show that despite routine screening of blood donors for hepatitis B, the transmission of HBV by blood remains possible via OBI and/or a seronegative window period; hence there is a need for active surveillance and foremost easier access to molecular tests for the screening of blood donors before transfusion.

The Using of Multiplex RT-qPCR for Pooled Samples to Detect Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus within Iraqi Blood Donors

Background: The blood of blood donors is screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection by enzyme immunoassay (EIA) in the National Center of Blood Bank in Baghdad. The residual risk of EIA negative samples is not estimated till now in Iraq. Objective: To detect HBV, HCV and HIV viruses within seronegative plasma of blood donors by a commercially available multiplex nucleic acid amplification tests (NAT) with mini-pooling system. Methods: One thousand (1000) blood donors were screened by EIA revealed negative results then NAT was performed on pools of samples, each pool contain ten seronegative plasmas (MP10) i.e., 100 minipools. Results: The detected positive minipools 10 seronegative plasmas by NAT for HBV, HCV and HIV were 3 MP10. Conclusion: The use of NAT appeared to be sensitive and reliable to detect occult HBV and overcome the seroconversion problem related with HCV and HIV within seronegative plasmas of blood donors. Therefore, the implementation of NAT with mini-pooling in addition to serological tests for routine blood donor screening will improve and ensure the safety of blood transfusion in Iraq. Keywords: Blood transfusion, widow period, multiplexes PCR Citation: Majid GS, Abdulamir AS, Ahmed AM, Aufi IM, Abdullah OI. The using of multiplex RT-qPCR for pooled samples to detect hepatitis B virus, hepatitis C virus, human immunodeficiency virus within Iraqi blood donors. Iraqi JMS. 2021; 19(1): 99-106. doi: 10.22578/IJMS.19.1.13

Filariasis and transfusion-associated risk: a literature review.

Filariae are parasitic worms that include the pathogens Loa loa, Onchocerca volvulus, Wuchereria bancrofti, Brugia spp. and Mansonella spp. which are endemic in parts of Africa, Asia, Asia-Pacific, South and Central America. Filariae have a wide clinical spectrum spanning asymptomatic infection to chronic debilitating disease including blindness and lymphedema. Despite successful eradication programmes, filarial infections remain an important -albeit neglected - source of morbidity. We sought to characterize the risk of transfusion transmission of microfilaria with a view to guide mitigation practices in both endemic and non-endemic countries. A scoping review of scientific publications as well as grey literature was carried out by a group of domain experts in microbiology, transfusion medicine and infectious diseases, representing the parasite subgroup of the International Society of Blood Transfusion. Cases of transfusion-transmitted filariasis are rare and confined to case reports of variable quality. Transfusion-associated adverse events related to microfilariae are confined to isolated reports of transfusion reactions. Serious outcomes have not been reported. No known strategies have been implemented, specifically, to mitigate transfusion-transmitted filariasis yet routine blood donor screening for other transfusion-transmissible infections (e.g. hepatitis B, malaria) may indirectly defer donors with microfilaremia in endemic areas. Rare examples of transfusion-transmitted filariasis, without serious clinical effect, suggest that filariasis poses low transfusion risk. Dedicated mitigation strategies against filarial transfusion transmission are not recommended. Given endemicity in low-resource regions, priority should be on the control of filariasis with public health measures.

Comparison of a New IgG-EIA for the Detection of Anti-Plasmodium Antibodies with Two Currently Used Assays

Background: Malaria is a mosquito-borne infectious disease caused by protozoan parasites of the genus Plasmodium. As migration of populations from endemic areas to Europe and overseas recreational travel to endemic regions increase, there is also a growing risk of transfusion-transmitted tropical diseases by blood components. Material and Methods: In the present study two routine Plasmodium spp. ELISA (CAPTIA™ Malaria EIA, Trinity Biotech, and Malaria EIA, BioRad) were compared with a new commercial ELISA (ELISA IgG, EUROIMMUN). From December 1, 2015 until November 30, 2016, 1,096 plasma samples from blood donors with a potential risk of malaria infection were collected at two blood transfusion centres in Germany and Switzerland. Results: The samples were tested comparatively with the ELISA from EUROIMMUN and the routine test used at the respective centre. Thirty-four of 595 (5.7%) tested blood samples from centre 1 and 49 of 501 (9.8%) tested blood samples from centre 2 showed reactivity on either or both ELISAs. All 83 reactive samples were sent for confirmation to the Diagnostic Centre of the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel, Switzerland. Sixteen samples, which previously were reactive in the routine Plasmodium spp. EIA assays, were proven positive after confirmation testing (i.e., 4 positive and 12 inconclusive results), indicating an anti-Plasmodium antibody prevalence in blood donations of 1.5%. From these 16 reactive samples, 13 were also detected by the index test, resulting in an assay sensitivity of 81.2%. A specificity of 98.6% was calculated (1,065/1,080 confirmed negative samples). The overall agreement with the reference centre was 95.8% in centre 1 and 94% in centre 2. Conclusion: The comparison of the new EUROIMMUN ELISA and the established CAPTIA™ Malaria EIA (Trinity Biotech) and Malaria EIA (BioRad) used for routine blood donor screening in two laboratory blood donation centres revealed that all tested ELISAs show comparable sensitivities and are equally suitable for anti-Plasmodium antibody screening in blood banks.

Immunochromatographic Test and Third Generation ELISA for Elucidating the Existence and Risk Factors of Anti-HCV Antibodies among Blood Donors from Swabi Pakistan

This cross sectional study was designed to investigate the frequency and potential risk factors of anti-HCV among blood donors as well as to elucidate the most sensitive screening method for routine practice in Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa Pakistan. A total of 3390 male volunteer blood donors with age range 18-55 years were screened for HCV-Ab through an immuno-chromatographic test (ICT) and 3rd generation-enzyme-linked immunosorbent assay (ELISA). The sensitivity of ICT and ELISA was also evaluated by comparing their results. Among 3390 donors, 59 (1.74 %) were found positive for HCV-Ab through ICT and 62 (1.82 %) were HCV-Ab positive by ELISA assay. The highest frequency rate (40.3 %) was observed among donors within the age group of 18-30 years followed by (27.4 %) among 31-40 years, (17.7 %) among 41-50 years and the lowest frequency (14.5 %) was found among 51-55 years. Dental treatment (37.0 %) was significantly associated with anti-HCV seropositivity followed by blood transfusion (20.9 %), major surgery (14.5 %), travel abroad and unknown reason (11.2 %) for each and the lowest anti-HCV association was observed among donors who shaved by the barbers (4.8 %). The results from ICT and ELISA indicated that ELISA is a more sensitive, and reliable technique for routine screening of blood donors to control infectious diseases particularly HCV infection.

Study of serological prevalence of transfusion transmissible infections among blood donors in a tertiary care hospital in North India

Introduction: Blood transfusion has been subjected to risk of transfusion transmissible infections such as HIV (Human Immunodeficiency Virus), HBV (Hepatitis B virus), HCV (Hepatitis C virus), syphilis etc. This risk has been reduced dramatically by routine screening of blood donors in blood banks. Objective: Our aim was to study the serological prevalence of transfusion transmissible infections (TTI) among donors and to find any correlation between these infections and blood groups. Methodology: This is a retrospective observational study for a period of one year (Dec 2014- Nov2015), and this study has been carried out in blood bank of tertiary care hospital of North India. Data of all voluntary and replacement donors retrieved from blood bank records i.e. ABO group, Rh type and results of serological tests performed. Results: Total 27,689 donors were screened during the study period and 559 donors were found seropositive for transfusion transmissible infections (2.01%). In which maximum 403 donors were positive for HBV (1.45%), followed by 93-HCV (0.33%), 42-syphilis (0.15%), 19-HIV (0.068%) and 2 for malaria antigen (0.007%). Seropositive cases for HBV, HCV and MP antigen were maximum in blood group B positive(B+) donors. While seropositive cases for syphilis were more encountered in A positive blood group(A+). HIV prevalence seen more in O positive group(O+). Conclusion: In this study, serological prevalence among apparently healthy donors was 2.01%. Which varies from 0.76% to 3% in different blood group donors. So strict screening is essential for all donors to prevent these life-threatening TTI. We observed no association between blood group antigens and these transfusion transmissible infections. So, more studies in larger level are required to find out any association. Keywords: Blood donors, Transfusion transmissible infections, HBV, HCV, HIV, Blood group.

Update on Hepatitis C Epidemiology: Unaware and Untreated Infected Population Could Be the Key to Elimination.

Globally, the World Health Organization (WHO) estimates that 71 million people have chronic hepatitis C virus (HCV) infection. A significant number of these will develop cirrhosis or liver cancer. Currently, during the COVID-19 outbreak, a high mortality rate has been found in patients with COVID-19 and cirrhosis. New direct-acting antiviral agents can cure more than 90% of HCV-infected patients. The new WHO strategy has introduced global goals against viral hepatitis, including a 30% reduction in new HCV cases and a 10% reduction in mortality by 2020. HCV transmission has changed considerably, reflecting both the evolution of medicine and health and social changes. The HCV is usually spread through blood-to-blood contact. After the discovery of HCV in 1989, antibody screening has drastically decreased the incidence of post-transfusion hepatitis. Nowadays, routine blood donor screening by nucleic acid amplification testing for the presence of HCV RNA has been introduced in many countries. It is conceivable that HCV screening could be offered to people born between 1946 and 1964 in the developed world and to people at high risk for HCV infection such as those who have received blood transfusions, blood products or organ donations before the 1990s, prisoners, health care workers, drug users and infants born to HCV-infected women. To achieve HCV elimination, health programmes should include improvement to access to health care services, increased screening and new projects to identify a submerged portion of patients with HCV infection. Submerged people with HCV infection are both people who are unaware of their condition and people diagnosed with HCV but not yet treated. Based on these premises, this review will examine and discuss the epidemiological changes in contracting HCV, highlighting the ways in which to identify a submerged portion of patients with HCV infection.

Viral Hepatitis in Hemodialysis: An update

Hepatitis outbreaks in hemodialysis (HD) patients and staff were reported in the late 1960s, and a number of hepatotropic viruses transmitted by blood and other body fluids have been identified. Hepatitis B virus (HBV) was the first significant hepatotropic virus to be identified in HD centers. HBV infection has been effectively controlled by active vaccination, screening of blood donors, the use of erythropoietin and segregation of HBV carriers. Hepatitis delta virus is a defective virus that can only infect HBV-positive individuals. Hepatitis C virus (HCV) is the most significant cause of non-A, non-B hepatitis and is mainly transmitted by blood transfusion. The introduction in 1990 of routine screening of blood donors for HCV contributed significantly to the control of HCV transmission. An effective HCV vaccine remains an unsolved challenge; however, pegylation of interferon-alfa has made it possible to treat HCV-positive dialysis patients. Unexplained sporadic outbreaks of hepatitis by the mid-1990s prompted the discovery of hepatitis G virus, hepatitis GB virus C and the TT virus. The vigilant observation of guidelines on universal precaution and regular virologic testing are the cornerstones of the effective control of chronic hepatitis in the setting of HD. Major recent advances in the viral diagnosis technology and the development of new oral, direct acting antiviral agents (DAAs) allow early diagnosis and better therapeutic response. The current update will review the recent developments, controversies and new treatment of viral hepatitis in HD patients.
 AKMMC J 2020; 11(2) : 128-136

Chagas Disease in the New York City Metropolitan Area.

BackgroundChagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor.MethodsWe review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment.ResultsThe most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twenty-seven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation.ConclusionsBased on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment.

COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National).

COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National).

Study of transfusion transmissible infections in donors in a tertiary care hospital in North Karnataka region

Study of transfusion transmissible infections in donors in a tertiary care hospital in North Karnataka region - JDPO- Print ISSN No: - 2581-3714 Online ISSN No:- 2581-3706 Article DOI No:- 10.18231/j.jdpo.2019.058, IP Journal of Diagnostic Pathology and Oncology-IP J Diagn Pathol Oncol

Prevalence of hepatitis G virus infection among 67,348 blood donors in mainland China

BackgroundHepatitis G virus (HGV) infection transmitted from blood donors is a concern in China, as many articles about HGV infection in Chinese blood donors from different provinces have been published. This study aimed to evaluate the overall prevalence of HGV infection in Chinese blood donors and analyse the potential risk of HGV infection through blood transfusion in China.MethodsWe performed a literature search in PubMed, EMBASE, Web of Science, the Chinese BioMedical Literature Database (CBM) and the China National Knowledge Infrastructure (CNKI) up to October 2018 regarding the prevalence of HGV in Chinese blood donors. Eligibility assessment and data extraction were conducted independently by 2 researchers, and meta-analysis was performed to synthesize the data. Heterogeneity was evaluated using Cochran’s Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the possible sources of heterogeneity. Publication bias was assessed using both funnel plot and Egger’s tests.ResultsA total of 102 studies with 67,348 blood donors published from 1996 to 2016 and covering 26 provinces or municipalities were included for further analyses. The pooled prevalence of HGV was 3.91% (95%CI: 3.18–4.71%) by enzyme immune assay/enzyme linked immunosorbent assay (EIA/ELISA) and 3.25% (95%CI: 2.35–4.26%) by polymerase chain reaction (PCR). The prevalence of HGV may be significantly affected by region, province or municipality and potentially by the paid/voluntary status of the blood donors. No significant difference was found between plasma and full blood donation.ConclusionsThe prevalence of HGV in blood donors from China was similar to that in blood donors from many other countries and higher than that of some other hepatitis viruses, such as hepatitis B virus. The risk of transfusion-transmitted HGV still exists after routine blood donor screening, especially in those patients coinfected with other hepatitis viruses and/or HIV. On the basis of our study, we may suggest adding HGV screening for blood transfusions in mainland China in the future.

Seroprevalence of human T-lymphotropic virus (HTLV) in blood donors in sub-Saharan Africa: a systematic review and meta-analysis.

Human T-cell lymphotropic viruses (HTLV) 1 and2 are endemic in sub-Saharan Africa (SSA), transfusion-transmissible and causally linked to various severe diseases. However, even in SSA countries with moderate to high endemicity, routine blood donor screening for HTLV is rarely, if ever, performed. Information on seroprevalence is limited.The aim of this review is to establish the prevalence of HTLV-1 andHTLV-1/2 among blood donors in sub-Saharan Africa. We systematically reviewed databases including EMBASE, MEDLINE and the Cochrane database library from their inception to June 2018. Studies presenting data on HTLV prevalence among blood donors in sub-Saharan Africa were included. A random-effect meta-analysis was conducted on all eligible studies. A total of 25 studies were included, representing 74119 blood donors, of whom over 80% (61002) were only tested for HTLV-1. The evidence base was high and moderate in quality. The pooled prevalence of the 17 studies that screened only for HTLV-1 and the nine studies that screened for HTLV-1/2 was 0·68 (95% CI: 0·29-1·60) and 1·11 (95% CI: 0·47-2·59) per 100 blood donors, respectively. The prevalence of HTLV-1 infection among blood donors is relatively low. The current review is intended to inform debates and decisions about best practices to prevent transfusion-transmitted HTLV in sub-Saharan Africa. Further work is required to determine the risk of infections by transfusion and the cost-effectiveness of any new measures such as routine screening.