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Estimation of the risk of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infectious donations entering the blood supply in England, 1993-2001.
Vox Sang. 2003 May; 84(4):274-86.VS

Abstract

BACKGROUND AND OBJECTIVES

The frequency of hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infectious donations entering the blood supply in England is too low to monitor using observational studies. The expected frequency of infectious donations can be estimated and these estimates may be used to contribute to monitoring of blood safety and used in the design of strategies to decrease the risk of transfusion-transmitted infections.

MATERIALS AND METHODS

The prevalence and incidence of hepatitis B surface antigen (HBsAg), and antibodies to HCV and HIV (anti-HCV and anti-HIV, respectively) in donors in England, between 1993 and 2001, were used together with data about the length of negative 'window-periods' of current assays for each of these markers and data about test performance, to estimate the number of infectious donations that enter the blood supply. The risks were calculated separately for donations from new donors and from repeat donors, and for the three time periods 1993-95, 1996-98 and 1999-01.

RESULTS

The estimated frequency of infectious donations entering the blood supply in England, between 1993 and 2001 was 1 in 260,000 for HBV and 1 in 8 million for HIV. For HCV, the frequency of infectious donations was 1 in 520,000 during 1993-98 and fell to 1 in 30 million during 1999-2001 when all donations were tested for HCV RNA. The frequency of HBV- and HCV-infectious donations entering the blood supply fell over these 9 years: the frequency of HIV-infectious donations remained essentially unchanged. The risk from donations from new donors was found to be approximately sevenfold higher than the risk from donations from repeat donors.

CONCLUSIONS

The risks of HBV-, HCV- or HIV-infectious donations entering the blood supply in England are very low, and have decreased since 1993. Although the accuracy of these estimates is imperfect, mainly owing to uncertainty in some assumptions and to small numbers of infections, they provide some quantification of the risk of HBV, HCV or HIV transmission by transfusion, and allow comparison of the magnitude of these risks for each infection and over time. The methods we have used have been developed and improved from previously published methods.

Authors+Show Affiliations

Soldan K
Public Health Laboratory Service, Communicable Disease Surveillance Centre, London, UK. kate.soldan@nbs.nhs.uk
Barbara JA
No affiliation info available
Ramsay ME
No affiliation info available
Hall AJ
No affiliation info available

MeSH

Blood DonorsEnglandHIV InfectionsHepatitis BHepatitis CHumansIncidencePrevalenceRiskSerologic TestsTransfusion Reaction

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12757501

Citation

Soldan, K, et al. "Estimation of the Risk of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Infectious Donations Entering the Blood Supply in England, 1993-2001." Vox Sanguinis, vol. 84, no. 4, 2003, pp. 274-86.
Soldan K, Barbara JA, Ramsay ME, et al. Estimation of the risk of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infectious donations entering the blood supply in England, 1993-2001. Vox Sang. 2003;84(4):274-86.
Soldan, K., Barbara, J. A., Ramsay, M. E., & Hall, A. J. (2003). Estimation of the risk of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infectious donations entering the blood supply in England, 1993-2001. Vox Sanguinis, 84(4), 274-86.
Soldan K, et al. Estimation of the Risk of Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Infectious Donations Entering the Blood Supply in England, 1993-2001. Vox Sang. 2003;84(4):274-86. PubMed PMID: 12757501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimation of the risk of hepatitis B virus, hepatitis C virus and human immunodeficiency virus infectious donations entering the blood supply in England, 1993-2001. AU - Soldan,K, AU - Barbara,J A J, AU - Ramsay,M E, AU - Hall,A J, PY - 2003/5/22/pubmed PY - 2004/3/11/medline PY - 2003/5/22/entrez SP - 274 EP - 86 JF - Vox sanguinis JO - Vox Sang VL - 84 IS - 4 N2 - BACKGROUND AND OBJECTIVES: The frequency of hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infectious donations entering the blood supply in England is too low to monitor using observational studies. The expected frequency of infectious donations can be estimated and these estimates may be used to contribute to monitoring of blood safety and used in the design of strategies to decrease the risk of transfusion-transmitted infections. MATERIALS AND METHODS: The prevalence and incidence of hepatitis B surface antigen (HBsAg), and antibodies to HCV and HIV (anti-HCV and anti-HIV, respectively) in donors in England, between 1993 and 2001, were used together with data about the length of negative 'window-periods' of current assays for each of these markers and data about test performance, to estimate the number of infectious donations that enter the blood supply. The risks were calculated separately for donations from new donors and from repeat donors, and for the three time periods 1993-95, 1996-98 and 1999-01. RESULTS: The estimated frequency of infectious donations entering the blood supply in England, between 1993 and 2001 was 1 in 260,000 for HBV and 1 in 8 million for HIV. For HCV, the frequency of infectious donations was 1 in 520,000 during 1993-98 and fell to 1 in 30 million during 1999-2001 when all donations were tested for HCV RNA. The frequency of HBV- and HCV-infectious donations entering the blood supply fell over these 9 years: the frequency of HIV-infectious donations remained essentially unchanged. The risk from donations from new donors was found to be approximately sevenfold higher than the risk from donations from repeat donors. CONCLUSIONS: The risks of HBV-, HCV- or HIV-infectious donations entering the blood supply in England are very low, and have decreased since 1993. Although the accuracy of these estimates is imperfect, mainly owing to uncertainty in some assumptions and to small numbers of infections, they provide some quantification of the risk of HBV, HCV or HIV transmission by transfusion, and allow comparison of the magnitude of these risks for each infection and over time. The methods we have used have been developed and improved from previously published methods. SN - 0042-9007 UR - https://www.unboundmedicine.com/medline/citation/12757501/Estimation_of_the_risk_of_hepatitis_B_virus_hepatitis_C_virus_and_human_immunodeficiency_virus_infectious_donations_entering_the_blood_supply_in_England_1993_2001_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓27]

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