Blood safety strategies for human T-cell lymphotropic virus in Europe.
BACKGROUND
To prevent the blood transmission of human T-cell lymphotropic virus (HTLV), different countries have introduced anti-HTLV blood screening. Furthermore, leucoreduction of blood components has been implemented to preclude the transmission of infectious agents present in white blood cells.


METHODS
To evaluate the current European strategies adopted to ensure the blood safety for HTLV, a European investigation spanning a period from 2003 to 2008 was carried out.


RESULTS
In 2003, of the 23 included countries, 11 performed anti-HTLV screening, four of which (Scandinavian countries) only did it on first-time donors. Norway and Finland stopped it in 2007 and 2008, respectively. Two groups may be defined according to increasing prevalence rates per 10 000 donations in first-time donors: Scandinavia and Ireland (0 to 0.17), France, the Netherlands and UK (0.45 to 0.48); Romania was clearly apart from all other participating countries (5.33). HTLV-positive donors (88.6%) either come from endemic areas (82.3%) or declare to have a sexual partner coming from endemic areas (6.3%). Of the 283 HTLV-positive donations that could be characterized, 6.6% were HTLV-II. Fourteen of 22 countries currently use systematic leucoreduction, at least in cellular blood components. Six countries perform both universal anti-HTLV screening and blood cell leucoreduction.


CONCLUSIONS
The implementation of leucoreduction did not modify the blood HTLVscreening policy, except for Norway and Finland. Several screening strategies in low endemic countries performing leucoreduction were discussed. However, the withdrawal of anti-HTLV screening should be decided after assessing the remaining HTLV transfusion risk.
Laperche
S
S
Reference National Centre for hepatitis B et C and HIV in transfusion, Institut National de la Transfusion Sanguine, Paris, France. slaperche@ints.fr
Worms
B
B
Pillonel
J
J
D001782:Blood Donors; D019353:Endemic Diseases; D005060:Europe; D015490:HTLV-I Infections / Q000517:prevention & control / Q000635:transmission*; D015491:HTLV-II Infections / Q000517:prevention & control / Q000635:transmission*; D015368:Human T-lymphotropic virus 1; D015367:Human T-lymphotropic virus 2; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008403:Mass Screening; D015995:Prevalence; D012449:Safety; D065227:Transfusion Reaction