OID-01. Probability of viral hepatitis markers detection in potential hematopoietic stem cell donors

Summary

Regular blood donors often become hematopoietic stem cell (HSC) donors as well. One of their advantages as donors is the fact that they have already passed a screening for bloodborne infections markers, most common of which are hepatitis B and C. Blood banks employ most sensitive modern diagnostic techniques including NAT and are able to screen even for early stages of infections. We performed a comparative analysis of hepatitis B and C markers frequency in various categories of blood donors, which are also candidates for HSC donor registry recruitment.

Materials and methods

Our study included 56,135 of regular FSBI RNIIHT FMBA blood donors and 16,240 first-time applicants for donation screened in 2000-2019. All of them were examined for bloodborne infections markers. The investigation extent and procedure, including diagnostic reagent specification, are regulated by Russian Federation Ministry of Health and Chief sanitary doctor’s orders. All blood donor donors were evaluated for hepatitis B, hepatitis C, HIV and syphilis markers via ELISA or immunochemiluminescent analysis using the Architect I 2000 SR automatic immunochemical analyzer. Since 2013 all blood donors has been examined for hepatitis B, hepatitis C and HIV nucleic acids presence with a help from a fully automated PCR-complex Cobas s201 system. The 2020-2021 donor survey results are not included in the analysis due to the changes introduced into donor department’s procedures during COVID-19 pandemic.

Results

Among the regular FSBI RNIIHT FMBA donors examined the viral hepatitis B markers incidence gradually decreased from 0.1% in 2000 to an average of 0.03% with no marker carriers found in some of the years. The hepatitis C markers were seen more often with 0.3% incidence in 2000 with subsequent average rate of 0.15% among subjects examined. Among the first-time donors the incidence of markers for both viruses was more significant with hepatitis B found in 1.3% in 2000 and then slightly decreasing to a rate of 0.5%, and hepatitis C markers been positive in 3.7% potential donors in 2000 and then seen in an average of 1.2% cases. From 2015 to 2019, the overall hepatitis markers positivity rate was 0.08% in regular donors and 1.4% in first-time ones, which demonstrates a slight general decrease infection frequency. In both blood donor groups the hepatitis C detection rate notably exceeds one for hepatitis B being about threefold higher.

Conclusion

Assumingly healthy people applying as candidates for donation are, nonetheless, infected in about 2% of cases (these figures are even higher in endemic regions) and are not accepted for donation due to bloodborne infections markers presence. A similar proportion of all potential first-time donors are likely to fail to become HSC Registry donors as well. In this regard, the donor social background, motivation and thorough questioning are of particular importance.

Keywords

Registry, hemopoietic stem cells, donors, bloodborne infections, hepatitis.