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Prinsze FJ, van de Laar T, Slot E, de Jong M, Bokhorst A, de Kort W, Zaaijer H, van den Hurk K. No increased risk of transfusion-transmissible infections after tattooing, body piercing, or acupuncture among blood donors in the Netherlands. Transfusion 2019; 59:2575-2583. [PMID: 31228271 DOI: 10.1111/trf.15421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the Netherlands, needle-related events (NREs) including tattoos, piercings, and acupuncture are a reason for temporary blood donor deferral. This study aims to evaluate whether donors with recent NREs had a higher risk of transfusion-transmissible infections (TTIs) compared to donors without recent NREs. STUDY DESIGN AND METHODS Data from 2006 through 2015 on all blood donation attempts in the Netherlands were collected. Multivariate regression models (for repeated measurements) were used to assess the associations between recent NREs and the acquisition of TTIs. Posttest counseling data were used to determine the most likely risk factor in TTI-positive new and repeat donors. RESULTS Recent NREs were documented in 97,518 out of 9,266,036 (1.1%) donation attempts; 14,097 (14.5%) NREs resulted in NRE-based donor deferral. Recent NREs reported pre-donation were not associated with an increased risk for TTIs. A total of 29 out of 287 TTI-positive donors (11 repeat donors, 18 new donors) reported a recent NRE pre- and/or post-donation. Recent NREs, all needle-stick injuries, were the likely route of transmission in 12 out of 287 (4.2%) of TTI-positive donors. The donor health questionnaire (DHQ) identified only 1 out of 12 TTI-linked NREs. Non-return after NRE deferral, any deferral, or no deferral was 24, 15, and 5%, respectively. DISCUSSION Recent tattoos, body piercings, or acupuncture were not associated with an increased risk for TTIs in Dutch donors. Given the lower return rates of donors following a temporary NRE-based deferral, we advocate ending blood donor deferral policies for acupuncture, tattooing, and body piercings, but not needle-stick injuries, in countries where these practices can be considered safe.
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Affiliation(s)
- Femmeke J Prinsze
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Laboratory of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Ed Slot
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Maarten de Jong
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Arlinke Bokhorst
- Department of Medical Donor Affairs, Sanquin Blood Bank, Amsterdam, The Netherlands.,TRIP National Hemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - Wim de Kort
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Hans Zaaijer
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands.,Department of Clinical Virology (CINIMA), Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
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Van Remoortel H, Moorkens D, Avau B, Compernolle V, Vandekerckhove P, De Buck E. Is there a risk of transfusion-transmissible infections after percutaneous needle treatments in blood donors? A systematic review and meta-analysis. Vox Sang 2019; 114:297-309. [PMID: 30972765 DOI: 10.1111/vox.12780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/07/2019] [Accepted: 03/17/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The donor medical questionnaire identifies a blood donor's history of known blood safety risks. Current Australian, Canadian, European and USA legislation temporarily defers blood donors who received different percutaneous needle treatments (i.e. tattooing, acupuncture and piercing) from blood donation. This systematic review aimed to scientifically underpin these deferrals by identifying the best available evidence on the association between percutaneous needle treatments and the risk of transfusion-transmissible infections (TTIs). MATERIALS AND METHODS Studies from three databases investigating the link between percutaneous needle treatments and TTIs (HBV, HCV and HIV infection) in blood donors were retained and assessed on eligibility by two reviewers independently. The association between percutaneous needle treatments and TTIs was expressed by conducting meta-analyses and calculating pooled effect measures (odds ratios (ORs) and 95% CIs). The GRADE methodology (Grades of Recommendation, Assessment, Development and Evaluation) was used to assess the quality of evidence. RESULTS We identified 1242 references and finally included 21 observational studies. Twenty studies assessed the link between percutaneous needle treatments and HCV infection and found that blood donors receiving these treatments had an increased risk of HCV infection (tattooing: pooled OR 5·28, 95% CI [4·33, 6·44], P < 0·00001 (low-quality evidence); acupuncture: pooled OR 1·56, 95% CI [1·17, 2·08], P = 0·03 (very low-quality evidence); and piercing: pooled OR 3·25, 95% CI [1·68, 6·30], P = 0·0005 (low-quality evidence)). CONCLUSION Percutaneous needle treatments may be associated with an increased HCV infection risk. Further high-quality studies are required to formulate stronger evidence-based recommendations on percutaneous needle treatments as a blood donor deferral criterion.
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Affiliation(s)
- Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Dorien Moorkens
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Bert Avau
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Cochrane Belgium, Belgian Centre for Evidence-Based Medicine (Cebam), Leuven, Belgium
| | - Veerle Compernolle
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Blood Services, Belgian Red Cross, Mechelen, Belgium
| | - Philippe Vandekerckhove
- Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Belgian Red Cross, Mechelen, Belgium
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
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3
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Epidemiology of HCV infection in the Central European region. Clin Exp Hepatol 2016; 2:2-6. [PMID: 28856264 PMCID: PMC5497410 DOI: 10.5114/ceh.2016.58849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/07/2016] [Indexed: 11/17/2022] Open
Abstract
Opinion leaders in each of four countries in the Central European region summarize the available data on hepatitis C virus (HCV) epidemiology. The overall prevalence of anti-HCV antibody reactivity in this region varies between 0.2% and 2.1%, the most prevalent HCV genotype is GT 1. The commonest route of transmission is intravenous drug abuse at present.
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4
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Cornberg M, Razavi HA, Alberti A, Bernasconi E, Buti M, Cooper C, Dalgard O, Dillion JF, Flisiak R, Forns X, Frankova S, Goldis A, Goulis I, Halota W, Hunyady B, Lagging M, Largen A, Makara M, Manolakopoulos S, Marcellin P, Marinho RT, Pol S, Poynard T, Puoti M, Sagalova O, Sibbel S, Simon K, Wallace C, Young K, Yurdaydin C, Zuckerman E, Negro F, Zeuzem S. A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel. Liver Int 2011; 31 Suppl 2:30-60. [PMID: 21651702 DOI: 10.1111/j.1478-3231.2011.02539.x] [Citation(s) in RCA: 304] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Decisions on public health issues are dependent on reliable epidemiological data. A comprehensive review of the literature was used to gather country-specific data on risk factors, prevalence, number of diagnosed individuals and genotype distribution of the hepatitis C virus (HCV) infection in selected European countries, Canada and Israel. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 13,000 articles were reviewed and 860 were selected based on their relevance. RESULTS Differences in prevalence were explained by local and regional variances in transmission routes or different public health measures. The lowest HCV prevalence (≤ 0.5%) estimates were from northern European countries and the highest (≥ 3%) were from Romania and rural areas in Greece, Italy and Russia. The main risk for HCV transmission in countries with well-established HCV screening programmes and lower HCV prevalence was injection drug use, which was associated with younger age at the time of infection and a higher infection rate among males. In other regions, contaminated glass syringes and nosocomial infections continue to play an important role in new infections. Immigration from endemic countries was another factor impacting the total number of infections and the genotype distribution. Approximately 70% of cases in Israel, 37% in Germany and 33% in Switzerland were not born in the country. In summary, HCV epidemiology shows a high variability across Europe, Canada and Israel. CONCLUSION Despite the eradication of transmission by blood products, HCV infection continues to be one of the leading blood-borne infections in the region.
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Affiliation(s)
- Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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Gyarmathy VA, Ujhelyi E, Neaigus A. HIV and selected blood-borne and sexually transmitted infections in a predominantly Roma (Gypsy) neighbourhood in Budapest, Hungary: a rapid assessment. Cent Eur J Public Health 2009; 16:124-7. [PMID: 18935777 DOI: 10.21101/cejph.a3479] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We assessed the prevalence of HIV and selected blood-borne and sexually transmitted infections among a convenience sample of 64 residents of Dzsumbuj, a predominantly Roma (Gypsy) neighbourhood in Budapest, Hungary. No cases of HIV were detected, while the prevalence of hepatitis B infection (anti-HBc) was 27% and syphilis prevalence was 2%. Romas (n = 50) were significantly more likely than non-Romas (n = 14) to have HAV antibodies (80% vs. 43%) and less likely to be HBV immunized (anti-HBs only; 6% vs. 29%). Current drug injectors (n = 13) were more likely than non-injectors (n = 51) to have antibodies against HAV (85% vs. 69%) and HCV (85% vs. 8%). While HIV has not been introduced in this population, risk conditions for a potentially explosive HIV epidemic are present. Health care policies should focus on expanding coverage for HAV and HBV immunizations, and access to HIV preventive services needs to be extended to marginalized, mostly minority populations, such as the Roma in Europe.
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Affiliation(s)
- V Anna Gyarmathy
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.
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Gonzalez-Perez I, González González YJ, Vina-Rodriguez A, Armas Cayarga A, Solís RL. The usefulness of Umelosa hepatitis C vírus qualitative kit as supplemental test for confirmation of hepatitis C virus infection. Rev Soc Bras Med Trop 2004; 37:25-7. [PMID: 15042178 DOI: 10.1590/s0037-86822004000100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Forty voluntary blood donors from two different blood banks in Havana, Cuba, who were repeatedly reactive on the routine screening of antibodies to hepatitis C virus, by Umelisa HCV test, were analyzed for the presence of HCV RNA using a nested PCR assay of the HCV 5' untranslated region, Umelosa HCV qualitative. Sera from 45 patients of a specialized gastroenterology consultation, positive to Umelisa HCV, were also assayed with the Umelosa HCV qualitative, to establish their condition related to the presence of HCV RNA previously to the indication of a treatment or after three, six or twelve months of antiviral therapy. Serum HCV-RNA was detected in 21/40 (52.5%) donors who had repeatedly positive ELISA results, confirming the HCV infection for them. In specialized consultation HCV-RNA was detected by PCR analysis in 30/45 (66%) analyzed sera.
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Alnaqdy A, Alfahdi A, Alkobaisi M, Kaminski GZ. Prevalence of autoantibodies in patients with hepatitis C virus infection in Oman. Ann Saudi Med 2003; 23:127-31. [PMID: 16985299 DOI: 10.5144/0256-4947.2003.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND HCV genotype patterns and HLA types in the Omani population may be unique. SUBJECTS AND METHODS Tests for 12 different autoantibodies were carried out on 50 HCV-infected patients and on 27 HCV-seronegative controls. An immunoassay for the detection of anti-HCV antibodies was performed on patient and control sera. HCV PCR was carried out on those sera which were positive for HCV antibodies. RESULTS All patients sera were positive for HCV antibodies and all control sera were negative. Sixty-six percent of patients were positive for at least one autoantibody. In contrast, only 33% of the controls showed positivity for one or more autoantibodies. CONCLUSION This study found a significant difference in the prevalence of autoantibodies between patients and controls, and between organ- and non-organ specific autoantibodies among the patients. A comparison with autoantibody patterns reported for HCV-infected patients in other parts of the world suggest that patterns in HCV-infected individuals in the Omani population are unique.
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Affiliation(s)
- A Alnaqdy
- Department of Microbiology and Immunology, College of Medicine, Sultanate of Oman
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Resti M, Azzari C, Bortolotti F. Hepatitis C virus infection in children coinfected with HIV: epidemiology and management. Paediatr Drugs 2003; 4:571-80. [PMID: 12175272 DOI: 10.2165/00128072-200204090-00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mothers with hepatitis C virus (HCV) and HIV coinfection are the major source of HCV/HIV coinfection in infancy and childhood. There is no known intervention capable of interrupting HCV spread from mother to child, while the majority of infant HIV infections occurring in the developed world can be prevented by antiretroviral prophylaxis in the mother and child, elective caesarean section, and formula-feeding. In the era preceding treatment of HIV infection with highly active antiretroviral therapy, HCV coinfection was of little concern because the short-term survival of patients with HIV infection prevented the slowly developing consequences of chronic hepatitis C. As the life expectancy of patients with HIV infection increased with therapy, HCV has emerged as a significant pathogen. Several lines of evidence in adult patients suggest that liver disease may be more severe in patients coinfected with HIV and that progression of HIV disease may be accelerated by HCV coinfection. Whether coinfected children may share these clinical patterns remains a matter of speculation. Chronic hepatitis C in otherwise healthy children is usually a mild disease; liver damage may be sustained and fibrosis may increase over the years, suggesting slow progression of the disease. Interferon-alpha has been the only drug used in the past decade to treat hepatitis C in children and adolescents, with average response rates of 20%. Preliminary results of treatment with interferon-alpha and ribavirin suggest that the efficacy would be greater with combined therapy. These treatment protocols have not yet been applied to children coinfected with HIV, but the increasing number of long-term survivors will probably prompt further investigation in the near future. At present, treating HIV disease and monitoring HCV infection and hepatotoxicity induced by antiretroviral drugs seem to be the more reasonable approach to HCV/HIV coinfection in childhood.
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Affiliation(s)
- Massimo Resti
- Department of Pediatrics, University of Florence, Florence, Italy.
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