PURSUING EPIDEMIOLOGICAL INVESTIGATION OF CASES OF POSSIBLE HBV OR HCV INFECTION OF THE RECIPIENT WITH TRANSFUSIONS OF DONOR BLOOD COMPONENTS


Cite item

Full Text

Abstract

Background. Nosocomial transmission of HBV and HCV is often believed to be associated with transfusion of inapparent infection blood. Nevertheless, recently both promotion of voluntary (fee free) donorship and the evolution of laboratory screening, including the introduction of high-sensitivity tests, have significantly reduced the transfusion-associated complications, including infectious ones. The incidence ratae of primary transfusion-transmitted infections in patients with hematological malignancies remains to be high. A lot of publications are devoted to epidemiological studies on the determination of the source of infection with parenteral viral hepatitis by virtue of molecular analysis of viral strains, which is one of the important tools for obtaining objective data on the presence or absence of epidemiological relationship in the investigation of iatrogenic cases of infection. However, there is still no clear algorithm for pursuing epidemiological investigations of such cases. The aim of this study was to develop the procedure for the epidemiological investigation of probable transfusion-transmitted HBV and HCV infection with the use of Laboratory Information System and Transfusiology Information System software in patients with hematological malignancies. Material and methods. 6 cases of primary HBV and 3 cases of primary HCV were registered in patients with hematological malignancies in the National Medical Research Center for Hematology. All patients had a history of blood transfusions. A two-steps procedure for the epidemiological investigation was developed. 5 epidemiological investigations were held according to this procedure. 35 archival blood samples (7 from patients and 28 from blood donors) were tested for serological and/or molecular markers of HBV and HCV to fulfill this. Results. First step of procedure includes the determination of the date of initial infection (IID). IID is an earliest point of maximal likelihood of the detection of viral markers by laboratory techniques. This value is calculated on the basis of the results of a comprehensive virological examination of the recipient. The second step includes a history of blood transfusions from IID up to date of initial detection of primary infection evaluation. Then the analysis of donor-recipient pairs should be executed for the detection of probable sources of infection. As the result of study 5 epidemiological investigations were held in accordance to the developed procedure and the Laboratory Information System and Transfusiology Information System software. Two of the five investigations cannot be completed because of donors’ rejection to undergo a follow-up examination. In other cases infection transmission through the blood transfusion was excluded. Conclusion. A standard operating procedure of epidemiological investigation of HBV or HCV transmission has been developed and implemented. In order to reveal the latent forms of these infections a protocol of viral screening in patients with hematological malignancies at the admission to hematology ward was also developed and implemented.

About the authors

T. Yu Romanova

National Medical Research Center for Hematology

Email: rybnaia@mail.ru
науч. сотр. науч. лаб. вирусной безопасности трансфузий крови и её компонентов ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

T. A Tupoleva

National Medical Research Center for Hematology

Email: ttupoleva@mail.ru; tupoleva.t@blood.ru
канд. мед. наук, врач-вирусолог, зав. научно-клиническим отделом вирусологической диагностики ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

Dmitry S. Tikhomirov

National Medical Research Center for Hematology

Email: tihomirovgnc@bk.ru
MD, PhD, senior researcher of the laboratory of viral safety of blood transfusion and its components of the National Research Center for Hematology, Moscow, 125167, Russia 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

N. G Yaroslavtseva

National Medical Research Center for Hematology

Email: ngyar@yandex.ru
канд. биол. наук, ст. науч. сотр. науч. лаб. вирусной безопасности трансфузий крови и её компонентов ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

E. N Ignatova

National Medical Research Center for Hematology

Email: ihele@yandex.ru
науч. сотр. науч. лаб. вирусной безопасности трансфузий крови и её компонентов ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

A. A Gulyaeva

National Medical Research Center for Hematology

Email: a1573@mail.ru
врач бактериолог, зав. отд-нием контроля крови на вирусные гепатиты, СПИД, сифилис ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

O. G Starkova

National Medical Research Center for Hematology

врач КЛД отд-ния контроля крови на вирусные гепатиты, СПИД, сифилис ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

T. V Gaponova

National Medical Research Center for Hematology

Email: gaponova.tatj@yandex.ru; gaponova.t@blood.ru
анд. мед. наук, заместитель Генерального директора по трансфузиологии ФГБУ «Гематологический научный центр» Минздрава России 4, Novyy Zykovskiy proezd, Moscow, 125167, Russia

References

  1. Туполева Т.А., Богословская Е.В., Грумбкова Л.О., Башкирова Л.Ю., Зайцев В.С., Ярославцева Н.Г. и др. Использование ПЦР для детекции ВГB и ВГC на станции переливания крови. Материалы VI всероссийской научно-практической конференции «Генодиагностика инфекционных болезней - 2007» (молекулярная диагностика - 2007). Москва, 28-30 ноября 2007 г; т. 1: 230-8.
  2. Burns K., Heslin J., Crowley B., Thornton L., Laoi B., Kelly E. et al. Nosocomial outbreak of hepatitis B virus infection involving two hospitals in the Republic of Ireland. J. Hosp. Infect. 2011; 78: 279-83. http://doi.org/10.1016/j.jhin.2011.02.016.
  3. Dumpis U., Kovalova Z., Jansons J., Cupane L., Sominskaya I., Michailova M. et al. An outbreak of HBV and HCV infection in a paediatric oncology ward: Epidemiological investigations and prevention of further spread. J. Med. Virol. 2003; 69: 331-8. doi: 10.1002/jmv.10293
  4. Голосова Т.В., Сомова А.В., Туполева Т.А., Филатов Ф.П. Тестирование доноров и эволюция посттрансфузионного гепатита. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 1999; 1: 32-6.
  5. Apostolou A., Bartholomew M., Greeley R., Guilfoyle S., Gordon M., Genese C. et al. Transmission of Hepatitis C Virus Associated With Surgical Procedures-New Jersey 2010 and Wisconsin 2011. American Journal of Transplantation. 2015; 15: 1436-40. PMID: 25719676.
  6. Büchner A., Du Plessis N., Reynders D., Omar F., Mayaphi S., Haeri Mazanderani A. Nosocomial outbreak of hepatitis B virus infection in a pediatric hematology and oncology unit in South Africa: Epidemiological investigation and measures to prevent further transmission. Pediatric blood & cancer. 2015; 62(11): 1914-9. doi: 10.1002/pbc.25605.
  7. Germain J., Carbonne A., Thiers V., Gros H., Chastan S., Bouvet E. et al. Patient-to-patient transmission of hepatitis C virus through the use of multidose vials during general anesthesia. Infection Control & Hospital Epidemiology. 2005; 26(09): 789-92. DOI: https://doi.org/10.1086/502618.
  8. Lanini S., Puro V., Lauria F.N., Fusco F., Nisii C., Ippolito G. Patient to patient transmission of hepatitis B virus: a systematic review of reports on outbreaks between 1992 and 2007. BMC medicine. 2009; 7: 15. doi: 10.1186/1741-7015-7-15.
  9. Cleveland J., Gray S., Harte J., Robison V., Moorman A., Gooch B. Transmission of blood-borne pathogens in US dental health care settings: 2016 Update. The Journal of the American Dental Association. 2016; 147(9): 729-38. DOI: http://doi.org/10.1016/j.adaj.2016.03.020.
  10. Diercke M., Monazahian M., Petermann H., Gerlich W., Schüttler C., Wend U. et al. Hepatitis B outbreak in a nursing home associated with reusable lancet devices for blood glucose monitoring, Northern Germany 2010. Journal of Medical Virology. 2015; 87(4): 583-8. doi: 10.1002/jmv.24104].
  11. Jasuja S., Thompson N., Peters P. et al. Investigation of hepatitis B virus and human immunodeficiency virus transmission among severely mentally ill residents at a long term care facility. PLoS One. 2012; 7: e43252. DOI: https://doi.org/10.1371/journal.pone.0043252.
  12. Туполева Т.А., Сомова А.В., Грумбкова Л.О., Ярославцева Н.Г., Гаранжа Т.А, Багрянцева С.Ю. и др. Вирусы гепатитов B и C у больных гематологической клиники. Новое в трансфузиологии. 2006; (43): 42-50.
  13. Туполева Т.А., Игнатова Е.Н., Тихомиров Д.С., Романова Т.Ю., Ярославцева Н.Г., Гуляева А.А. и др. Динамика инфицированности вирусам гепатитов В и С больных заболеваниями системы крови. Гематология и трансфузиология. 2016; 61(1): 75.
  14. Suryaprasad A., Basavaraju S., Hocevar S., Theodoropoulos N., Zuckerman R., Hayden T. et al. Transmission of hepatitis C virus from organ donors despite nucleic acid test screening. American Journal of Transplantation. 2015; 15(7): 1827-35. doi: 10.1111/ajt.13283.
  15. Centers for Disease Control and Prevention. Notes from the field: Transplant-transmitted hepatitis B virus-United States, 2010. MMWR Morb. Mortal Wkly Rep. 2011; 60: 1087. PMID: 21849966.
  16. Campo D., Xia G., Dimitrova Z., Lin Y., Forbi J., Ganova-Raeva L. et al. Accurate genetic detection of hepatitis C virus transmissions in outbreak settings. Journal of Infectious Diseases. 2016; 213(6): 957-65. DOI: https://doi.org/10.1093/infdis/jiv542.
  17. Лабораторная диагностика инфекционных болезней. Справочник / под ред. В.И. Покровского, М.Г. Твороговой, Г.А. Шипулина. М.; БИНОМ: 2013.
  18. Vermeulen M., Dickens., Lelie N., Walker E., Coleman C., Keyter M. et al. Hepatitis B virus transmission by blood transfusion during 4 years of individual-donation nucleic acid testing in South Africa: estimated and observed window period risk. Transfusion. 2012; 52: 880-92. doi: 10.1111/j.1537-2995.2011.03355.x.
  19. Lerat H., Hollinger F. Hepatitis C virus (HCV) occult infection or occult HCV RNA detection? Journal of Infectious Diseases. 2004; 189(1): 3-6. DOI: https://doi.org/10.1086/380203.
  20. Chen A., Hoare M., Shankar A., Allison M., Alexander G., Michalak T. Persistence of hepatitis C virus traces after spontaneous resolution of hepatitis C. PloS One. 2015; 10(10); e0140312. doi: 10.1371/journal.pone.0140312.s001.

Copyright (c) 2017 Eco-vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies