TY - JOUR
T1 - Blood transfusion safety in the country of Georgia
T2 - collateral benefit from a national hepatitis C elimination program
AU - Bloch, Evan M.
AU - Kipiani, Eteri
AU - Shadaker, Shaun
AU - Alkhazashvili, Maia
AU - Gvinjilia, Lia
AU - Kuchuloria, Tinatin
AU - Chitadze, Nazibrola
AU - Keating, Sheila M.
AU - Gamkrelidze, Amiran
AU - Turdziladze, Alexander
AU - Getia, Vladimer
AU - Nasrullah, Muazzam
AU - Averhoff, Francisco
AU - Izoria, Mariam
AU - Skaggs, Beth
N1 - Funding Information:
EK, SS, MA, LG, TK, NC, SMK, AG, AT, VG, MN, FA, MI, and BS have disclosed no conflicts of interest. EMB is an investigator on trials to evaluate pathogen reduction technology funded by the US government. EMB has received education speaker fees for Grifols Diagnostics Solutions.
Funding Information:
The authors are grateful to all the clinicians and laboratory staff who are participating in the Georgia HCV Elimination Program, especially Tengiz Tsertsvadze (Infectious Diseases, AIDS, and Clinical Immunology Research Center, Tbilisi, Georgia), Maia Butsashvili (Neolab, Tbilisi, Georgia), David Metreveli, (Medical Center Mrcheveli, Tbilisi, Georgia) and Lali Sharvadze (Joint Georgian-French Hepatology Clinic Hepa, Tbilisi, Georgia). Further, we wish to acknowledge all partners on the HCV Elimination Program: Georgian Harm Reduction Network, Tbilisi, Georgia; World Health Organization, Geneva, Switzerland; Extension for Community Healthcare Outcomes (ECHO), University of New Mexico, New Mexico, USA; Liver Institute and Foundation for Education and Research (LIFER), Boston, Massachusetts, USA; Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland; Médecins du Monde (MDM), Paris, France; Abbott Laboratories, Chicago, Illinois, USA; Bristol University, Bristol, UK; Georgia State University, Atlanta, Georgia, USA; The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland; Vitalant Research Institute, San Francisco, California, USA; Johns Hopkins University, Maryland, USA; and Gilead Sciences, Foster City, California, USA.
Publisher Copyright:
© 2020 AABB
PY - 2020/6/1
Y1 - 2020/6/1
N2 - BACKGROUND: In April 2015, the government of Georgia (country) initiated the worldʼs first national hepatitis C elimination program. An analysis of blood donor infectious screening data was conducted to inform a strategic plan to advance blood transfusion safety in Georgia. STUDY DESIGN AND METHODS: Descriptive analysis of blood donation records (2015-2017) was performed to elucidate differences in demographics, donor type, remuneration status, and seroprevalence for infectious markers (hepatitis C virus antibody [anti-HCV], human immunodeficiency virus [HIV], hepatitis B virus surface antigen [HBsAg], and Treponema pallidum). For regression analysis, final models included all variables associated with the outcome in bivariate analysis (chi-square) with a p value of less than 0.05. RESULTS: During 2015 to 2017, there were 251,428 donations in Georgia, representing 112,093 unique donors; 68.5% were from male donors, and 51.2% of donors were paid or replacement (friends or family of intended recipient). The overall seroprevalence significantly declined from 2015 to 2017 for anti-HCV (2.3%-1.4%), HBsAg (1.5%-1.1%), and T. pallidum (1.1%-0.7%) [p < 0.0001]; the decline was not significant for HIV (0.2%-0.1%). Only 41.0% of anti-HCV seropositive donors underwent additional testing to confirm viremia. Infectious marker seroprevalence varied by age, sex, and geography. In multivariable analysis, first-time and paid donor status were associated with seropositivity for all four infectious markers. CONCLUSION: A decline during the study period in infectious markers suggests improvement in blood safety in Georgia. Areas that need further improvement are donor recruitment, standardization of screening and diagnostic follow-up, quality assurance, and posttransfusion surveillance.
AB - BACKGROUND: In April 2015, the government of Georgia (country) initiated the worldʼs first national hepatitis C elimination program. An analysis of blood donor infectious screening data was conducted to inform a strategic plan to advance blood transfusion safety in Georgia. STUDY DESIGN AND METHODS: Descriptive analysis of blood donation records (2015-2017) was performed to elucidate differences in demographics, donor type, remuneration status, and seroprevalence for infectious markers (hepatitis C virus antibody [anti-HCV], human immunodeficiency virus [HIV], hepatitis B virus surface antigen [HBsAg], and Treponema pallidum). For regression analysis, final models included all variables associated with the outcome in bivariate analysis (chi-square) with a p value of less than 0.05. RESULTS: During 2015 to 2017, there were 251,428 donations in Georgia, representing 112,093 unique donors; 68.5% were from male donors, and 51.2% of donors were paid or replacement (friends or family of intended recipient). The overall seroprevalence significantly declined from 2015 to 2017 for anti-HCV (2.3%-1.4%), HBsAg (1.5%-1.1%), and T. pallidum (1.1%-0.7%) [p < 0.0001]; the decline was not significant for HIV (0.2%-0.1%). Only 41.0% of anti-HCV seropositive donors underwent additional testing to confirm viremia. Infectious marker seroprevalence varied by age, sex, and geography. In multivariable analysis, first-time and paid donor status were associated with seropositivity for all four infectious markers. CONCLUSION: A decline during the study period in infectious markers suggests improvement in blood safety in Georgia. Areas that need further improvement are donor recruitment, standardization of screening and diagnostic follow-up, quality assurance, and posttransfusion surveillance.
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U2 - 10.1111/trf.15815
DO - 10.1111/trf.15815
M3 - Article
C2 - 32542715
AN - SCOPUS:85085077121
SN - 0041-1132
VL - 60
SP - 1243
EP - 1252
JO - Transfusion
JF - Transfusion
IS - 6
ER -