Reducing the risk of transfusion-transmitted infectious disease markers in blood and blood component donations: Movement from remunerated to voluntary, non-remunerated donations in Lithuania from 2013 to 2020

Abstract

Lithuania has a long history of remunerated donations. The first steps towards voluntary, non-remunerated blood and blood component donations started in 2004. Lithuania achieved 99.98% voluntary non-remunerated donations (VNRDs) in 2020. This study aimed to assess the risk of transfusion-transmitted infectious (TTI) disease markers for remunerated donations in comparison with VNRDs in Lithuania from 2013 to 2020. Data were obtained from the Lithuanian Blood Donor Register. The prevalence was calculated as the rate between the number of confirmed positive results for all TTI disease markers (serological anti-HCV, HBsAg, Ag/anti-HIV 1 and 2, and syphilis, and/or HCV, HBV, and HIV-1 NAT) per 100 donations. The relative risk of infectious disease markers for remunerated donations was then estimated. In total, 796310 donations were made. Altogether, 2743 donations were positive for TTI markers as follows: HCV, 1318; HBV, 768; syphilis, 583; and HIV 1 and 2, 74. The prevalence of confirmed TTI markers were 2.86, 0.97, 0.18, and 0.04 per 100 first-time remunerated donations, first-time VNRDs, repeat remunerated donations, and repeat VNRDs, respectively. Remunerated first-time and repeat donations had a statistically higher prevalence of TTI disease markers than VNRDs. First-time and repeat remunerated donations had statistically significantly higher relative risks of confirmed TTI disease markers than VNRD. In conclusion, the risks of TTI disease markers for remunerated first-time and repeat blood and its component donations are significantly higher than those for VNRDs.

Prevalence and Residual Risk of HIV in Volunteer Blood Donors of Zhejiang Province, China, from 2018 to 2022

“…Tis may be attributed to continuous measures taken by the blood services in Zhejiang Province to prevent the spread of HIV in recent years. Blood services can efectively reduce the number of HIV-infected individuals among blood donors through measures such as improving public awareness and understanding of blood donation and blood safety, as well as self-exclusion of blood donors [28][29][30]. Other contributing factors include the low HIV prevalence in Zhejiang Province and a decreasing HIV infection rate among the general population since 2020 (https://www.cdc.zj.cn/).…”

The availability of plasma donors and plasma: A sociologist's perspective

“…Monetary incentives for blood donors may crowd out altruistic motivations, exploit vulnerable donors [2] and jeopardize blood safety [29] because they might decrease donor compliance with eligibility criteria that determine whether the donation is safe for donor and patient.…”

“…The ethical question of whether it is desirable to offer incentives for what we often consider an act of altruism and solidarity has repeatedly been raised [24–27], with arguments against donor compensation showing limited basis in scientific evidence [26, 28]. Monetary incentives for blood donors may crowd out altruistic motivations, exploit vulnerable donors [2] and jeopardize blood safety [29] because they might decrease donor compliance with eligibility criteria that determine whether the donation is safe for donor and patient. However, improved testing for infectious disease markers has developed and improved such that infections in transfusion recipients, while not absent, have been minimized.…”

Limited evidence, lasting decisions: How voluntary non‐remunerated plasma donations can avoid the commercial one‐way street

“…Within Lithuania, blood and blood components donations shifted from mostly remunerated to mostly VNRD due to national programmes promoting VNRD following Lithuania's EU membership [15]. A study examining this unique within‐country natural experiment showed higher prevalence of transfusion‐transmitted infectious (TTI) disease markers for remunerated donations compared to donations based on VNRD from 2013 to 2017 [15]. This is consistent with previous research that found lower TTI disease markers for voluntary compared to paid donors in the Democratic Republic of Congo [16] and Nigeria [17].…”