Vere Borra, Augusta Darius, Kim Dockx, Veerle Compernolle, Paul Lambrechts, Philippe Vandekerckhove, Emmy De Buck
{"title":"Dental care as a risk factor for transfusion transmissible infections in blood donors: a systematic review and meta-analysis.","authors":"Vere Borra, Augusta Darius, Kim Dockx, Veerle Compernolle, Paul Lambrechts, Philippe Vandekerckhove, Emmy De Buck","doi":"10.1097/XEB.0000000000000219","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>The deferral policy for blood donation after dental care is based on the precautionary principle. The aim of this systematic review is to give an overview of the scientific evidence concerning the risk of transfusion transmissible infections (TTIs) after dental care.</p><p><strong>Materials and methods: </strong>Four databases were searched: Medline, the Cochrane Library, Embase and Web of Science. Screening was independently performed by two reviewers. The quality of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation principle. A meta-analysis was performed to assess the association between dental treatment and TTI markers.</p><p><strong>Results: </strong>A total of 22 studies were included. Meta-analysis of 16 studies showed an increased association of TTIs with dental treatment, however with large heterogeneity. Subgroup analysis revealed a significant increased association of hepatitis B virus (HBV) with dental treatment [odds ratio 1.79, 95% confidence interval (1.48; 2.18)]. There was conflicting evidence concerning the risk of hepatitis C virus (HCV). One study could not demonstrate a statistically significant increased association of human T-lymphotropic virus type I with dental treatment. Three studies showed a significant increased association of HCV with tooth extraction [odds ratio 1.48, 95% confidence interval (1.11; 1.97)]. Finally, there is conflicting evidence concerning the risk of HBV or HCV after dental cleaning. One study could not demonstrate an association between HIV and dental cleaning. All evidence is of very low certainty and results cannot be considered precise.</p><p><strong>Conclusion: </strong>Studies of high quality concerning the risk of TTI after dental care in blood donors are scarce. An association of HBV after dental treatment and HCV after tooth extraction was demonstrated but evidence is of very low certainty. The currently identified studies are of too low certainty to make any suggestions regarding the value of deferral or deferral times.</p>","PeriodicalId":55996,"journal":{"name":"International Journal of Evidence-Based Healthcare","volume":"18 2","pages":"170-187"},"PeriodicalIF":0.0000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/XEB.0000000000000219","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Evidence-Based Healthcare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/XEB.0000000000000219","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: The deferral policy for blood donation after dental care is based on the precautionary principle. The aim of this systematic review is to give an overview of the scientific evidence concerning the risk of transfusion transmissible infections (TTIs) after dental care.
Materials and methods: Four databases were searched: Medline, the Cochrane Library, Embase and Web of Science. Screening was independently performed by two reviewers. The quality of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation principle. A meta-analysis was performed to assess the association between dental treatment and TTI markers.
Results: A total of 22 studies were included. Meta-analysis of 16 studies showed an increased association of TTIs with dental treatment, however with large heterogeneity. Subgroup analysis revealed a significant increased association of hepatitis B virus (HBV) with dental treatment [odds ratio 1.79, 95% confidence interval (1.48; 2.18)]. There was conflicting evidence concerning the risk of hepatitis C virus (HCV). One study could not demonstrate a statistically significant increased association of human T-lymphotropic virus type I with dental treatment. Three studies showed a significant increased association of HCV with tooth extraction [odds ratio 1.48, 95% confidence interval (1.11; 1.97)]. Finally, there is conflicting evidence concerning the risk of HBV or HCV after dental cleaning. One study could not demonstrate an association between HIV and dental cleaning. All evidence is of very low certainty and results cannot be considered precise.
Conclusion: Studies of high quality concerning the risk of TTI after dental care in blood donors are scarce. An association of HBV after dental treatment and HCV after tooth extraction was demonstrated but evidence is of very low certainty. The currently identified studies are of too low certainty to make any suggestions regarding the value of deferral or deferral times.
背景和目的:牙科护理后的延迟献血政策是基于预防原则。本系统综述的目的是概述有关牙科护理后输血传播感染(tti)风险的科学证据。资料和方法:检索Medline、Cochrane Library、Embase和Web of Science四个数据库。筛选由两名评论者独立完成。采用推荐分级、评估分级、发展分级和评价分级原则评价证据质量。进行荟萃分析以评估牙科治疗与TTI标志物之间的关系。结果:共纳入22项研究。16项研究的荟萃分析显示，TTIs与牙科治疗的相关性增加，但存在很大的异质性。亚组分析显示，乙型肝炎病毒(HBV)与牙科治疗的相关性显著增加[优势比1.79,95%可信区间(1.48;2.18)]。关于丙型肝炎病毒(HCV)风险的证据相互矛盾。一项研究不能证明人类t淋巴细胞I型病毒与牙科治疗有统计学意义的增加关联。三项研究显示HCV与拔牙的相关性显著增加[优势比1.48,95%可信区间(1.11;1.97)]。最后，关于洗牙后感染HBV或HCV的风险存在相互矛盾的证据。一项研究无法证明艾滋病毒和洗牙之间的联系。所有证据的确定性都很低，结果不能被认为是精确的。结论:关于献血者牙科护理后TTI风险的高质量研究很少。证实了牙科治疗后HBV与拔牙后HCV的相关性，但证据的确定性非常低。目前确定的研究报告的确定性太低，无法就推迟或推迟时间的价值提出任何建议。
期刊介绍：
The International Journal of Evidence-Based Healthcare is the official journal of the Joanna Briggs Institute. It is a fully refereed journal that publishes manuscripts relating to evidence-based medicine and evidence-based practice. It publishes papers containing reliable evidence to assist health professionals in their evaluation and decision-making, and to inform health professionals, students and researchers of outcomes, debates and developments in evidence-based medicine and healthcare.
The journal provides a unique home for publication of systematic reviews (quantitative, qualitative, mixed methods, economic, scoping and prevalence) and implementation projects including the synthesis, transfer and utilisation of evidence in clinical practice. Original scholarly work relating to the synthesis (translation science), transfer (distribution) and utilization (implementation science and evaluation) of evidence to inform multidisciplinary healthcare practice is considered for publication. The journal also publishes original scholarly commentary pieces relating to the generation and synthesis of evidence for practice and quality improvement, the use and evaluation of evidence in practice, and the process of conducting systematic reviews (methodology) which covers quantitative, qualitative, mixed methods, economic, scoping and prevalence methods. In addition, the journal’s content includes implementation projects including the transfer and utilisation of evidence in clinical practice as well as providing a forum for the debate of issues surrounding evidence-based healthcare.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
