Transfusion‐Transmitted Infections

Abstract

SUMMARY Although the risks of transfusion‐transmitted infection are currently very small compared with other medical interventions, the perception remains that these risks are significant. Infection risks from recognized agents for which we select appropriate candidate donors and/or perform systematic laboratory testing include inadequacy of donor selection, errors in laboratory testing or inventory control, insensitivity of screening tests, and donations in the “window period” prior to seroconversion. Potential threats from emerging (or newly recognized) microbial agents remain a continuing reality. To date, however, GB‐virus C and TT‐virus, though transfusion‐transmissible, appear to be non‐pathogenic. Human herpes virus 8 (HHV‐8), the causative agent of Kaposi's sarcoma, has not been demonstrated to be transfusion‐transmissible and the potential threat from variant Creutzfeldt‐Jakob disease (vCJD) has also not yet been demonstrated. However, the risk from bacteria is demonstrable and, as viral risk is reduced, becomes proportionately more significant. Interventions to reduce risk include leukodepletion, extension of nucleic acid testing and/or testing for hepatitis C virus antigen, use of combined human immunodeficiency antigen plus antibody tests, and extended interventions to reduce bacterial risks. The safety yields and cost/benefit ratio of these interventions (often very low) need careful consideration, especially in the context of commercial pathogen inactivation systems soon to become available.

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