Residual risk of transfusion-transmitted human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infections in Italy.
BACKGROUND
Estimating the risk of transfusion-transmitted infections (TTIs) is essential for monitoring blood safety. The residual risk of TTI was estimated for nearly 90 percent of the blood supply in Italy.


METHODS
Data were analyzed from 1,079,281 repeat donors, corresponding to 5,361,000 donations made in blood transfusion centers throughout Italy in the period 1999 through 2001. The residual risk of transfusion-transmitted human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections was estimated with the incidence rate-window period model. The denominator for the incidence rate (i.e., the number of person-years at risk) was estimated on a sample of 5850 donors.


RESULTS
The risk of an infectious donation entering the blood supply, per 1 million donations, was 1.91 (probable range, 0.52-3.32) for HIV, 16.74 (9.57-24.01) for HCV, and 69.16 (43.12-102.70) for total HBV (adjusted for vaccination and hepatitis B surface antigen transience).


CONCLUSIONS
In Italy, the estimated residual risk of TTI is apparently low, particularly for HIV infection. Although the estimated risks are higher for HCV and HBV, the introduction of mandatory viral detection tests for HCV in 2002 should account for an 80 percent reduction in the HCV risk. Moreover, the ongoing HBV vaccination program will contribute to reducing the risk of transfusion-transmitted HBV.
Gonzalez
Margarita
M
Transfusion Methodology Section, Department of Hematology, Oncology and Molecular Medicine, Instituto Superiore Di Sanità, Rome, Italy.
Règine
Vincenza
V
Piccinini
Vanessa
V
Vulcano
Francesca
F
Giampaolo
Adele
A
Hassan
Hamisa Jane
HJ
D015492:AIDS Serodiagnosis; D000328:Adult; D000368:Aged; D001782:Blood Donors; D001803:Blood Transfusion / Q000331:legislation & jurisprudence / Q000592:standards; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000331:legislation & jurisprudence; D008875:Middle Aged; D012306:Risk; D012698:Serologic Tests; D065227:Transfusion Reaction
D006514:Hepatitis B Surface Antigens