An estimate of the current risk of transmitting blood-borne infections through blood transfusion in Italy.
We conducted a retrospective cohort study to estimate the incidence of major blood-borne agents among Italian blood donors and calculated the risk of infection among blood recipients using the 'incidence/window period model'. The study was conducted among 46 180 blood donors enrolled in six blood centres between 1994 and 1999. During follow-up, seven new infections were confirmed: three donors seroconverted for anti-human immunodeficiency virus (HIV); two for anti-hepatitis C virus (HCV); and two showed hepatitis B surface antigen (HBsAg) reactivity; no cases of syphilis were observed. The incidence rates per 100 000 person/years were: 4.06 (95% CI: 0.82-11.85) for HIV; 2.41 (95% CI: 0.29-8.70) for HCV; and 2.70 (95% CI: 0.32-9.77) for HBsAg; the incidence for total hepatitis B virus (HBV) infection was 9.77 per 100 000 person/years (95% CI: 1.16-35.36). The estimated risk of an infectious blood unit not being detected was: 2.45 (95% CI: 0.13-12.33) per 1 million units for HIV; 4.35 (95% CI: 0.30-22.39) for HCV; and 15.78 (95% CI: 1.16-84.23) for HBV. Overall, an estimated 22.58 per 1 million units are infected. In Italy, the risk of transfusion-transmitted infections is low and is similar to that in other western countries. The introduction of new more sensitive screening tests could reduce the residual risk of transfusion-transmitted infection by 40-80%.
Tosti
M E
ME
Reparto di Epidemiologia Clinica, Istituto Superiore di Sanità, Servizio Trasfusionale e Immunoematologia, Università La Sapienza, Rome, Italy. me.tosti@iss.it
Solinas
S
S
Prati
D
D
Salvaneschi
L
L
Manca
M
M
Francesconi
M
M
Ciuffreda
M
M
Girelli
G
G
Mele
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001782:Blood Donors; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000635:transmission; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000276:immunology / Q000635:transmission; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D065227:Transfusion Reaction; D014777:Virus Diseases / Q000635:transmission*
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens