Current concepts in the prevention of pathogen transmission via blood/plasma-derived products for bleeding disorders

Abstract

The pathogen safety of blood/plasma-derived products has historically been a subject of significant concern to the medical community. Measures such as donor selection and blood screening have contributed to increase the safety of these products, but pathogen transmission does still occur. Reasons for this include lack of sensitivity/specificity of current screening methods, lack of reliable screening tests for some pathogens (e.g. prions) and the fact that many potentially harmful infectious agents are not routinely screened for. Methods for the purification/inactivation of blood/plasma-derived products have been developed in order to further reduce the residual risk, but low concentrations of pathogens do not necessarily imply a low level of risk for the patient and so the overall challenge of minimising risk remains. This review aims to discuss the variable level of pathogenic risk and describes the current screening methods used to prevent/detect the presence of pathogens in blood/plasma-derived products

Host genetic factors and clinical parameters influencing the occult hepatitis C virus infection in patients on chronic hemodialysis: Is it still a controversial infection?

“…Transfusion transmitted infection (TTI) is a serious challenge to transfusion services worldwide. The TTI problem is directly related to the prevalence of infection in the blood donor community …”

“…The TTI problem is directly related to the prevalence of infection in the blood donor community. 1,2 One of the main TTIs is hepatitis C virus (HCV) infection. Despite the implementation of control and precautionary plans and screening the blood products for HCV, this infection is still the main health problem in patients requiring multiple blood transfusions, such as those undergoing hemodialysis.…”

Emerging Infectious Diseases and Blood Safety: Modeling the Transfusion-Transmission Risk

“…and hepatitis C virus (HCV) have been reduced to very low probabilities [2,3]. This has been achieved by a combination of community education, non-remunerated voluntary blood donations, pre-donation donor questionnaires designed to elicit risk behaviors, universal donor screening, pathogen inactivation procedures incorporated into the production of plasma-derived products and the availability of pathogen reduction technologies for fresh blood components [2,[4][5][6][7]. Additionally, most countries perform serological screening for Treponema pallidum (syphilis) [8], while a number also screen for antibodies to human T-cell lymphotropic virus types 1 and 2 (anti-HTLV-1/2) [9,10] and bacterial contamination of platelet components [11].…”

How I approach: Previously untreated patients with severe congenital hemophilia A

“…Since the licensure of recombinant factor products in the 1990s, rFVIII has been the treatment of choice in the United States. However, with the implementation of advanced donor screening, plasma donation guidelines, and virus filtration and inactivation strategies, pathogen transmission is greatly reduced, and there have been no viral transmission from clotting factor products in over 25 years. Nonetheless, the hemophilia community remains vigilant for emerging pathogens.…”