Evaluating the Risk of Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus Among High-risk Deferred Blood Donors, Based on Deferral Reasons.

Abstract

Background: Blood donor selection is a crucial stage in reducing the risk of transfusion-transmissible infections (TTIs) and ensuring the safety of blood components. The objective of this study is to evaluate the impact of each question regarding deferral reasons on the risk of TTIs.

Methods: This study was conducted in twenty blood transfusion centers between March 1, 2018, and September 30, 2019, including high-risk deferred volunteers from seven different groups. All samples from deferral volunteers were screened for HBsAg, anti-HCV, and HIVAg/Ab. Negative samples were pooled and tested for HBVDNA and HCVRNA. The results were compared with those of eligible donors. The association between high-risk behaviors and TTIs was analyzed using risk ratios and 95% confidence intervals.

Results: Out of 2525 high-risk deferred volunteers, the risk of TTIs based on deferral reasons was as follows: a history of positive results of infectious tests RR: 401.6 ( 95% CI : 276.7‒582.8), drug abuse RR: 133.3 (61.9‒287.0), exposure to someone else's blood RR:39.8 (5.7‒275.3), high-risk procedures RR:14.3 (7.9‒25.9), unsafe sexual behaviors RR:9.03 (4.1‒20.1), imprisonment and medical interventions RR=0.0. The deferred group had significantly higher rates of viral markers compared to eligible donors. Furthermore, one reactive HCV RNA was detected in anti-HCV negative samples.

Conclusion: This study showed that deferring blood donations based on a history of positive results from infectious tests, drug abuse, unsafe sexual behaviors, exposure to someone else's blood, and high-risk procedures is effective for ensuring blood safety. These deferral practices should be maintained. We recommend that other deferral criteria should be regularly evaluated for effectiveness.