Blood transfusion safety in the country of Georgia: collateral benefit from a national hepatitis C elimination program

Abstract

BACKGROUND In April 2015, the government of Georgia (country) initiated the worldʼs first national hepatitis C elimination program. An analysis of blood donor infectious screening data was conducted to inform a strategic plan to advance blood transfusion safety in Georgia. STUDY DESIGN AND METHODS Descriptive analysis of blood donation records (2015‐2017) was performed to elucidate differences in demographics, donor type, remuneration status, and seroprevalence for infectious markers (hepatitis C virus antibody [anti‐HCV], human immunodeficiency virus [HIV], hepatitis B virus surface antigen [HBsAg], and Treponema pallidum). For regression analysis, final models included all variables associated with the outcome in bivariate analysis (chi‐square) with a p value of less than 0.05. RESULTS During 2015 to 2017, there were 251,428 donations in Georgia, representing 112,093 unique donors; 68.5% were from male donors, and 51.2% of donors were paid or replacement (friends or family of intended recipient). The overall seroprevalence significantly declined from 2015 to 2017 for anti‐HCV (2.3%‐1.4%), HBsAg (1.5%‐1.1%), and T. pallidum (1.1%‐0.7%) [p < 0.0001]; the decline was not significant for HIV (0.2%‐0.1%). Only 41.0% of anti‐HCV seropositive donors underwent additional testing to confirm viremia. Infectious marker seroprevalence varied by age, sex, and geography. In multivariable analysis, first‐time and paid donor status were associated with seropositivity for all four infectious markers. CONCLUSION A decline during the study period in infectious markers suggests improvement in blood safety in Georgia. Areas that need further improvement are donor recruitment, standardization of screening and diagnostic follow‐up, quality assurance, and posttransfusion surveillance.

Risk factors and genotype distribution of hepatitis C virus in Georgia: A nationwide population-based survey

“…Even though universal HCV antibody screening of blood donations in Georgia started in 1997, our previous analysis found that receiving a blood transfusion after 1997 was still associated with high anti-HCV prevalence, suggesting the need for further improvements in blood safety [24]. However, a recent analysis of blood transfusion programs in Georgia showed positive trends in blood safety since 2015, suggestive of collateral benefit from a national hepatitis C elimination program [30].…”

Guidance for the procurement of COVID‐19 convalescent plasma: differences between high‐ and low‐middle‐income countries

“…Manyif not most -CCP donors are expected to be first-time donors and will be unfamiliar with the donation process. First-time donor status introduces considerations of risk: first-time donors are higher risk of TTIs and donation-associated adverse events than repeat donors [23][24][25][26][27]. Repeat donation selects for healthier individuals as criteria for donation (e.g.…”

“…PR would allay concerns related to viral transmission from CCP. Pertinent to LMICs, CCP donors are more likely to be first-time donors and thus have a higher risk of TTIs [23,[25][26][27]. In countries that issue recovered FFP through a quarantine system routinely, PR would address the risk of a the major TTIs (e.g.…”

Hepatitis C care cascade among patients with and without tuberculosis: findings from nationwide programs in the country of Georgia, 2015-2020

“…This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available diagnostic and treatment services for TB countrywide [26,[28][29][30][31]…”