Prevalence of transfusion-transmitted infections in Saudi Arabia blood donors

Abstract

Objectives: To establish a nationwide epidemiological profile of transfusion-transmittable infection (TTI) markers among seemingly healthy blood donors to update policies required to ensure blood safety. Methods:A nationwide, cross-sectional study was designed to examine donor demographics and TTI prevalence during 2020 using data provided by the Ministry of Health, Saudi Arabia.Results: Collectively, a total of 375,218 whole blood units were donated, of which 32,758 (8.7%) were Original Articleexcluded due to TTI-related risk. The exclusion was based on a positive nucleic acid amplification test (NAT) or seroreactivity to hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV-I/II), syphilis, or malaria. Notably, the central (37.6%) and southern (33%) regions were the epicenters of TTI-reactive blood donors. Hepatitis B virus markers accounted for 85.7% and were the overall most prevalent of TTI-positive donations, followed by HCV at 5.9% and syphilis at 5.6%. In particular, anti-HBc and HBsAg were most prevalent in the south, while HBV NAT was highest in the center. Conclusion:Hepatitis B virus, HCV, and syphilis carry the greatest risk of TTI in Saudi Arabia. Including HBsAg screening is a necessary precautious measure to maintain blood safety.

Comment on: Prevalence of transfusion-transmitted infections in Saudi Arabia blood donors

“…We appreciate the efforts of the Ministry of Health (MOH) team in publishing valuable statistics about TTI detection rates in the Kingdom,which national professionals in blood banking and transfusion medicine were eager to know. 1 The data shared 1 show the detected rates of TTI are generally acceptable, but we found the rate of positive testing for hepatitis B virus nucleic acid testing (NAT) of 2.5% in Riyadh alarming. High rates of TTI detection among potential donors indicate the need for improved donor selection.…”

“…We have read with interest the article published in Saudi Medical Journal on Prevalence of transfusiontransmitted infections in Saudi Arabia blood donors nationwide; cross-sectional study. 1 Safe blood supply has always been considered fundamental to the modern healthcare system in Saudi Arabia. Despite the global call for patient blood management implementation and recent innovations in pharmaceutical alternatives, the demand for blood transfusion remains relatively constant globally and in Saudi Arabia.…”

“…3 This emphasizes the point raised by the authors regarding the need to more detailed information when discussing TTIs in the Kingdom. 1 In addition to the anticipation of more data sharing by MOH, we also encourage all those working in the fields of transfusion medicine, public health, and infectious diseases in Saudi Arabia to conduct and publish about TTI. Single cases of transmission of an infection may lead to significant findings and raise the need for major changes.…”

The future of blood services amid a tight balance between the supply and demand of blood products: Perspectives from the ISBT Young Professional Council

“…Access to blood donation varies across jurisdictions. Several LMICs heavily rely on family replacement donors (FRDs), who tend to be first‐time donors and, as a result, exhibit a higher risk of TTIs [60, 61]. However, many are committed to establishing a pool of volunteer, non‐remunerated blood donors (VNRDs) and to converting first‐time donors (FRDs and VNRDs) to repeat donors and have had some success [62].…”

Assessment of the impact of pathogen reduction technologies on the neutralizing activity of COVID-19 convalescent plasma.

“…Since CCP-donors are like first-time donors with an elevated risk for window-period transmission of blood borne viruses, pathogen reduction treatment (PRT) may be a way mitigating such risk. In Saudi Arabia, the NAT/serology positivity rate for transfusion-transmissible infections was 8.7% in 2020, with HBV as most prevalent marker, followed by HCV and Treponema [12] Transmission despite NAT/serology testing is occasionally reported from multiple countries, for example two recent cases of HCV transmission in Germany [13] , nine cases of HBV transmission in Slovenia [14] and transfusion of an HIV contaminated unit in France [15] . Furthermore there are concerns regarding a blood-transmissible potential future variant, even there is currently no evidence for SARS-CoV-2 blood transmissibility [16] (efficient inactivation of SARS-CoV-2 in plasma has been shown with amtosalen/UVA (AS) [17] and riboflavin/UVB (RB) [18] technologies).Studies conducted to date assessing the impact of PRT on CCP have several weaknesses, in particular small sample numbers and a non-standardized methodology, making it difficult to assess differences between technologies [19] .…”