[Expanded serologic infection testing of autologous blood donors: a report of experiences].
OBJECTIVE
The transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV-1/2) may cause serious disease in the recipient in cases of inadvertant homologous transfusion of autologous blood. Therefore data on the incidence of these infections in autologous blood donors are necessary.


METHODS
We tested 7,438 autologous donations from 3,030 patients for anti-HIV, anti-HCV, and HBsAG. In addition, we tested all patients for antibodies to Treponema pallidum and hepatitis B virus core antigen (anti-HBc) and for elevated serum ALT levels. Confirmation tests were performed only for positive anti-HIV-EIAs.


RESULTS
The frequencies of anti-HIV, anti-HCV, and HBsAG were 0.05, 2.8 and 0.6% of all units. The rate of anti-HCV decreased from 4.0 to 3.4% after introduction of a 2nd generation EIA but was only 0.6% using a 3rd generation EIA. Anti-HBc was positive in 9.4%, the TPHA test in 0.5%. ALT was above 45 U/I in 1.2%, but outside the sex related normal range in 8.4% of all units. 23.7% of all donations positive for anti-HIV, anti-HCV, or HBsAG showed at least one pathologic surrogate test; 7.5% of all surrogate marker positive units contained anti-HIV, anti-HCV, or HBsAG.


CONCLUSIONS
The overall frequency of anti-HIV, anti-HCV, and HBsAG was only 3.45% of all autologous donations and was reduced further after introduction of 2nd and 3rd generation anti-HCV-EIAs. However, the rate of surrogate marker positive units was 10.9%. The overlap between both groups was remarkable. We conclude from our data that procedures to minimize the risk of inadvertant homologous transfusion of autologous blood are necessary despite the implementation of screening tests in autologous donation programs.
Zimmermann
R
R
Abteilung für Transfusionsmedizin und Hämostaseologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland.
Weisbach
V
V
Wittmann
G
G
Zingsem
J
J
Neidhardt
B
B
Eckstein
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001804:Blood Transfusion, Autologous; D017848:Blood-Borne Pathogens; D002648:Child; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission*; D006509:Hepatitis B / Q000175:diagnosis / Q000635:transmission*; D006526:Hepatitis C / Q000175:diagnosis / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012698:Serologic Tests
Erweiterte infektionsserologische Testung von Eigenblutspenden: Ein Erfahrungsbericht.