Searching for unknown transfusion-transmitted hepatitis viruses: A binational cohort study of 1.5 million transfused patients

for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Resumé

Background: Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications. Methods: Analyses were based on the Scandinavian Donations and Transfusions (SCANDAT2) database. Cox regression models were used to estimate the hazard ratio (HR) of developing chronic liver disease in recipients of blood from donors who later developed any chronic liver disease compared to recipients who received blood transfusion from healthy donors. We also studied whether the risk of liver disease was increased in patients who received units from 'high-risk' donors, defined as donors who had a higher than expected occurrence of liver disease amongst their previous recipients. All analyses were stratified before and after 1992 to account for the effect of screening for hepatitis C virus. Results: A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992, with HRs for any liver disease of 1.38 [95% confidence interval (CI), 1.30-1.46] and 0.99 (95% CI, 0.91-1.07), before and after 1992, respectively. Similarly, blood components from 'high-risk' donors conferred increased risks before, but not after 1992. Conclusions: Our data provide no evidence for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare.

OriginalsprogEngelsk
TidsskriftJournal of Internal Medicine
Vol/bind284
Udgave nummer1
Sider (fra-til)92-103
ISSN0954-6820
DOI
StatusUdgivet - 2018

Fingeraftryk

Torque teno virus
Hepatitis Viruses
Liver Diseases
Cohort Studies
Hepacivirus
Confidence Intervals
Hepatitis C
Hepatitis B
Proportional Hazards Models
Hepatitis B virus
Public Health
Databases

Citer dette

for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III). / Searching for unknown transfusion-transmitted hepatitis viruses : A binational cohort study of 1.5 million transfused patients. I: Journal of Internal Medicine. 2018 ; Bind 284, Nr. 1. s. 92-103.
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title = "Searching for unknown transfusion-transmitted hepatitis viruses: A binational cohort study of 1.5 million transfused patients",
abstract = "Background: Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications. Methods: Analyses were based on the Scandinavian Donations and Transfusions (SCANDAT2) database. Cox regression models were used to estimate the hazard ratio (HR) of developing chronic liver disease in recipients of blood from donors who later developed any chronic liver disease compared to recipients who received blood transfusion from healthy donors. We also studied whether the risk of liver disease was increased in patients who received units from 'high-risk' donors, defined as donors who had a higher than expected occurrence of liver disease amongst their previous recipients. All analyses were stratified before and after 1992 to account for the effect of screening for hepatitis C virus. Results: A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992, with HRs for any liver disease of 1.38 [95{\%} confidence interval (CI), 1.30-1.46] and 0.99 (95{\%} CI, 0.91-1.07), before and after 1992, respectively. Similarly, blood components from 'high-risk' donors conferred increased risks before, but not after 1992. Conclusions: Our data provide no evidence for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare.",
keywords = "Hepatitis, Transfusion medicine",
author = "G. Edgren and H. Hjalgrim and K. Rostgaard and V. Dahl and K. Titlestad and C. Erikstrup and A. Wikman and R. Norda and A. Majeed and {for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)}",
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Searching for unknown transfusion-transmitted hepatitis viruses : A binational cohort study of 1.5 million transfused patients. / for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III).

I: Journal of Internal Medicine, Bind 284, Nr. 1, 2018, s. 92-103.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Searching for unknown transfusion-transmitted hepatitis viruses

T2 - A binational cohort study of 1.5 million transfused patients

AU - Edgren, G.

AU - Hjalgrim, H.

AU - Rostgaard, K.

AU - Dahl, V.

AU - Titlestad, K.

AU - Erikstrup, C.

AU - Wikman, A.

AU - Norda, R.

AU - Majeed, A.

AU - for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)

PY - 2018

Y1 - 2018

N2 - Background: Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications. Methods: Analyses were based on the Scandinavian Donations and Transfusions (SCANDAT2) database. Cox regression models were used to estimate the hazard ratio (HR) of developing chronic liver disease in recipients of blood from donors who later developed any chronic liver disease compared to recipients who received blood transfusion from healthy donors. We also studied whether the risk of liver disease was increased in patients who received units from 'high-risk' donors, defined as donors who had a higher than expected occurrence of liver disease amongst their previous recipients. All analyses were stratified before and after 1992 to account for the effect of screening for hepatitis C virus. Results: A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992, with HRs for any liver disease of 1.38 [95% confidence interval (CI), 1.30-1.46] and 0.99 (95% CI, 0.91-1.07), before and after 1992, respectively. Similarly, blood components from 'high-risk' donors conferred increased risks before, but not after 1992. Conclusions: Our data provide no evidence for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare.

AB - Background: Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications. Methods: Analyses were based on the Scandinavian Donations and Transfusions (SCANDAT2) database. Cox regression models were used to estimate the hazard ratio (HR) of developing chronic liver disease in recipients of blood from donors who later developed any chronic liver disease compared to recipients who received blood transfusion from healthy donors. We also studied whether the risk of liver disease was increased in patients who received units from 'high-risk' donors, defined as donors who had a higher than expected occurrence of liver disease amongst their previous recipients. All analyses were stratified before and after 1992 to account for the effect of screening for hepatitis C virus. Results: A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992, with HRs for any liver disease of 1.38 [95% confidence interval (CI), 1.30-1.46] and 0.99 (95% CI, 0.91-1.07), before and after 1992, respectively. Similarly, blood components from 'high-risk' donors conferred increased risks before, but not after 1992. Conclusions: Our data provide no evidence for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare.

KW - Hepatitis

KW - Transfusion medicine

U2 - 10.1111/joim.12762

DO - 10.1111/joim.12762

M3 - Journal article

C2 - 29624755

AN - SCOPUS:85046026589

VL - 284

SP - 92

EP - 103

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0954-6820

IS - 1

ER -