dr. m. maghsudlu

With the establishment of the lookback process in the country, an essential part of the lookback in 2006 is based on post-donation information which is crucial in ensuring blood safety. The most important item in post-donation information is donor high-risk behaviors that were not disclosed during the donor selection process. In this study, trends in lookback units related to high-risk behaviors in plasma for contract fractionation were examined over time.

This cross-sectional study collected data from authorized blood transfusion centers and categorized them according to risk factor categories. The Cochran-Armitage test was employed to assess the linear trend in lookback risk over time and to separate the different causes of lookback related to high-risk behaviors. The relative risk index was calculated and reported as the effect size of the Cochran-Armitage test with a 95% confidence interval using the epitools package of R software.

The number of lookback units based on post-donation information decreased during the study (RR: 0.73; 95% CI: 0.68-0.78; p< 0.001). Furthermore, significant changes were observed in trends of risk factors leading to lookbacks, including drug abuse (p= 0.001), high-risk sexual behavior (p< 0.001) with the decreasing trend, and tattoos (p= 0.01), cupping (Hijama) and acupuncture (p< 0.001) with the increasing trend. 

   According to this study, in the donor selection process, it is recommended to pay more attention to high-risk behaviors that are important in the number of lookback units and blood safety.

Human lymphotropic virus type I mainly infects lymphocytes. For the detection of this virus, mainly nucleated cells are evaluated. Due to the short longevity of cells, sample collection is a challenge. The purpose of the study was to investigate the presence of HTLV-1 virus in genomic DNA released from cells in plasma and to determine its viral load in Western blot-positive blood donors.

In this descriptive study, 30 HTLV-1 positive Western blot donors were evaluated. Using an extraction kit, genomic DNA was extracted from plasma and isolated PBMC using Ficol. A nested PCR test was used to confirm the presence of HTLV-1 virus. A real-time PCR quantitative test by Sybergreen method was used to determine the amount of virus load.

The average age of subjects was 42.9 ± 13.5 years; 93.3% of them were male and 6.6% female. LTR gene region was detected by nested PCR method in 80% of plasma and 100% of PBMC samples. The median viral loads in plasma and PBMC were 1.90 Copies/µL and 20 copies/106 PBMC, respectively.

Conclusions  :

To detect the HTLV-1 virus by molecular method, the HTLV-1 provirus  DNA released from cells, in the plasma can be used when peripheral blood mononuclear cells are unavailable. It has also been observed that the virus load in the plasma of asymptomatic carriers is approximately 10 times lower than in PBMC.

Assessing the sensitivity, specificity and positive predictive value (PPV) of blood-borne infections detection kits are important indicators in the evaluation and use of the kit.

The present study is a descriptive study. The sensitivity of the kit was calculated using the panels of Boston Biomedica Company, definite positive samples of Iranian patients, and the specificity and PPV of the kits in two groups of low-risk )1646371) and high-risk (2525). The results were analyzed with descriptive statistics, SPSS 26, and OR statistical test. (p < 0.05)

In evaluating Monalisa HBs Ag ULTRA, Bio-Rad, and Genscreen ULTRA HIV Ag/Ab kits, Bio-Rad is even more sensitive than reference kits (Enzygnost HBsAg 6.0, Siemens, HIV Ag/Ab Biomerieux) and in the case of Monalisa Anti-HCV kit PLUS Version 3, Bio-Rad sensitivity was equal to 98.6% of the reference kit (Ortho HCV 3.0 Enhanced SAVE). The results of the specificity evaluation in the high-risk group by three kits of HBs Ag, Anti HCV, and HIV Ag/Ab were 99.56%, 100%, and 99.80%, respectively. The results of the evaluation of PPV in the same three kits in the low-risk group were 41.4%, 31.30%, and 6.07% and in the high-risk group they were reported to be 72.5%, 100% and 37.5%, respectively.

Conclusions  :

The results of the present study, in addition to the appropriateness of sensitivity and specificity of the studied kits, showed a significant difference in PPV in communities with different viral prevalence and emphasized the importance of paying attention to prevalence in order to select kits and methods used for viral screening or diagnosis.

Hepatitis C (HCV) infection is one of the main causes of chronic hepatitis diseases all over the world. HCV is a transfusion transmitted virus and a serious threat to general health. HCV genotyping has an important role in tracing routes of infection. This study aimed at investigating the changes in  distribution pattern of HCV genotypes among Iranian blood donors.

In this cross sectional study, 239 HCV confirmed blood donors from Jun. 2015 to Nov. 2017 were included. Semi nested PCR method was used for amplifying the NS5B  region of HCV genome. PCR products were sequenced and HCVgenotypes were determined by searching the sequences in Basic Local Alignment Search Tool (BLAST). Phylogenetic tree was constructed to confirm HCV genotypes. STATA 13 software was used for data analysis. 

In 106 (44.35% ± 6.3%) out of 239 participants, HCV genotype was determined and confirmed. In phylogenetic tree, studied sequences formed three separated clusters. Genotype 3a, 1a and 1b were the common genotypes.

Conclusions :

It seems that molecular epidemiology of HCV infection did not change based on variability of genotypes but changes in the frequency of genotypes have been occurred as a result of replacement of genotype 1a by genotype 3a during the last decade among Iranian blood donors.

Considering the importance of donor selection process in blood safety, this study aimed at comparison of frequency of intravenous drug use (IDU) among accepted HCV positive blood donors in different regions of Iran.

This cross sectional-analytical study was conducted on  serologically confirmed HCV positive blood donors who referred to blood transfusion centers for counseling all over the country during November 2015 to May 2017. All provinces were classified in three regions. IDU status and demographic specification of participants were analyzed using questionnaires. Chi square, fisher exact and ANOVA with STATA software version 13 were used for statistical analysis.

Participants, according to the number of provinces, sample size and geographical proximity to three areas were classified including  76 from North; 105 from West-South and 90 from East- Center individuals with the mean ages of 37.73 ±  8.27, 38.83 ± 8.80 and 36.86 ± 8.63 and  history of IDU of 37 (48.68%), 45 (42.86%) and 41 (45.56%), respectively. No significant differences between different regions of the country were found in the frequency of IDU voluntary blood donors with hepatitis C, age, gender, education status, marriage status (p > 0.05).

Conclusions:

Approximately half of the voluntary blood donors with hepatitis C were IDUs. The frequency of IDU was similar among donors from different regions of Iran. Considering the fact that studied donors were found eligible in donor selection and donated the blood, though rejected during the screening phase, conducting research on the issue can increase the quality of blood donor selection and blood safety.