Transfusion-transmitted infections among multitransfused patients in Iran: a review.

摘要: SUMMARY . Transfusion-transmitted infections (TTI)continue tobe a major challenge for Blood transfusionorganizations across the world. The problem is moreseriousinthedevelopingcountrieswithlowereconomicmeans. Multitransfused patients (MTPs) in thesecountries are at higher risk of infection, and studies ofinfection these can be useful index forexamining blood safety filters place. presentarticlereviewsthesituationinIran,whereprevalenceofthe viruses concern, namely,hepatitisB virus,hepatitisC virus(HCV)andhuman immunodeficiencyvirus,studiedinthesepatientsisreportedovera9-yearperiod. It demonstrated that HCV mostprevalent TTI remains health problemfor patients.Key words: Iran Transfusion Organization,Iranian multitransfused patients, transfusion-trans-mitted viruses.The supply developed world has neverbeen as safe it now. During past two decades,initiatedlargelybytheAIDSepidemic,therehavebeendramatic progressive reductions trans-fusion-transmitted clinically significant blood-borneinfections. This level been accomplishedas result extensive research to characterizetransfusion-transmitted pathogens, development ofstrategies measure infection rates donor aswellasinrecipientpopulations,characterizationoftheearlyviraemia,andimplementationofmorerestrictivedonor eligibility criteria increasingly sensitivelaboratory techniques screening.Blood now so countries thatclassic approaches, such prospective follow-up andretrospectivelook-backstudiesofrecipients orstudiesthat determine frequency missed inscreened donors, transfusion arevirtually unable document events. Riskestimates namely,human immunodeficiency virus (HIV), hepatitis Cvirus (HCV) B (HBV), nowbased on mathematical models integrate datafromfourpotentialsourcesofrisk:(i)markernegativewindow-phase donations, (ii) immune variant viralstrains, (iii) persistent antibody-negative (immunosi-lent)carriersand(iv)proceduraltestingerrors(Kleinman& Busch, 2000; 2001). These model-basedestimates indicate current residual HCV, HIVand HBV being 1:30 million, 1:8 million 1:260000, respectively, England (Soldan et al., 2003). InCanada,the residualriskfor HIV isestimatedas1/7 8million; HBV, reported 1/153 000 forHCV, 1/2 3 which lowered 1/13million using nucleic acid (NAT) (OBrienet 2007). In United States, recent reports men-tion 1:1 9 andHCVand1:205 000for (Busch 2005; Davenport & Mintz,2007).The exciting developments medicinethathaveoccurredinthepastyearsrepresentprogressin practice only where beenimplemented accessible. However, implementa-tion methods brought limited safetyagainst expense. There growing dis-crepancyintheimplementationofthesedevelopmentsbetween industrialized developing world.The underlying mechanisms complex dependon many factors infrastructure, cultural andbehaviouralcircumstances,humanresources,politicalstructure economy.Transfusion-transmitted (TTI) thereforecontinue serious underdeveloped