title: [Relevance of safety measures to avoid HTLV transmission by transfusion in 2014].
abstract: In high-income countries, the safety of blood transfusion related to viruses has reached a very high level, especially thanks to the implementation of multiple measures aimed at reducing the transfusion risk. The cost-effectiveness of these preventive measures is frequently discussed due to global financial resources, which are more and more limited. Hence, the revision of safety strategies is a key issue, especially when these strategies are redundant, as those implemented to avoid Human T-cell Lymphotropic Virus (HTLV) transmission, which are based on both antibodies screening and leucoreduction of blood products. The residual risk of the transmission of HTLV by transfusion has been recently estimated at 1 in 20 million donations (2010-2012) in France (excluding overseas territories). This estimation did not take into account the leucoreduction, which appears to be a very efficient preventive measure as the virus is strictly intra-cellular. To help decision-making, we have evaluated some parameters related to HTLV blood transmission. Firstly, the probability that an incident occurring during the leucoreduction process affects a HTLV-positive blood donation has been estimated at 1 in 178 million. Estimation of clinical consequences of HTLV-positive transfusions would affect 1 to 2 transfused-patients without leucoreduction, and one recipient every 192 years in case of 10% failures of the filtration method. Obviously, despite a risk, which appears to be controlled, HTLV screening will be disputed as soon as the efficiency of leucoreduction to totally prevent virus blood transmission will be proven and when pathogen inactivation methods are generalized to all blood cellular products.
authors.affiliation: Département d'études des agents transmissibles par le sang, Centre national de référence pour les hépatites B et C et du VIH en transfusion, Institut national de la transfusion sanguine, 6, rue Alexandre-Cabanel, 75015 Paris, France. Electronic address: slaperche@ints.fr.
authors.forename: S
authors.initials: S
authors.lastname: Laperche
authors.affiliation: Département des maladies infectieuses, institut de veille sanitaire, 12, rue du Val-d'Osne, 94410 Saint-Maurice, France.
authors.forename: J
authors.initials: J
authors.lastname: Pillonel
mesh_terms: D001782:Blood Donors; D058731:Blood Safety / Q000379:methods* / Q000592:standards; D003362:Cost-Benefit Analysis; D003657:Decision Making; D015480:Deltaretrovirus Antibodies / Q000097:blood; D006800:Deltaretrovirus Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D046148:Donor Selection / Q000191:economics / Q000379:methods; D005602:France / Q000453:epidemiology; D006801:Humans; D047589:Leukocyte Reduction Procedures / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D011336:Probability; D065227:Transfusion Reaction; D014766:Viremia / Q000175:diagnosis / Q000635:transmission; D038301:Virus Inactivation
chemical_list: D015480:Deltaretrovirus Antibodies
keywords: Blood safety; Déleucocytation; Dépistage; HLTV; Leucoreduction; Screening; Sécurité transfusionnelle