Prospective investigation of transfusion transmitted infection in recipients of over 20 000 units of blood

doi:10.1136/bmj.320.7232.403

BMJ 2000;320:403-406 ( 12 February )

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Prospective investigation of transfusion transmitted infection in recipients of over 20 000 units of blood

Fiona A M Regan, research fellow, Patricia Hewitt, lead consultant in transfusion microbiology, John A J Barbara, lead scientist in transfusion microbiology, Marcela Contreras, executive director,

National Blood Service, London and South East Zone, North London Centre, London NW9 5BG

Correspondence to: P Hewitt patricia.hewitt{at}nbs.nhs.uk

Objectives: To follow up recipients of 20 000 units ofblood to identify any transmissions of infections through bloodtransfusion.
Design: Follow up study of recipients oftransfusion.
Setting: 22 hospitals in northLondon.
Participant: Adult patients who had recently beentransfused.
Main outcome measures: Patients had further blood samples taken at9 months that were tested for markers of hepatitis B and C andHIV and human T cell leukaemia/lymphoma virus type I or II (HTLV)infections. Recent infections were distinguished from pre-existinginfections by comparison with blood samples taken beforetransfusion.
Results: 9220 patients were recruited, and 5579 recipientsof 21 923 units of blood were followed up. No transfusion transmittedinfections were identified. The incidence of transfusion transmittedinfections was 0 in 21 043 units (95% confidence interval forrisk 0 to 1 in 5706 recipients) for hepatitis B; 0 in 21 800 units(0 to 1 in 5911 recipients) for hepatitis C; 0 in 21 923 units(0 to 1 in 5944 recipients) for HIV; and 0 in 21 902 units (0to 1 in 5939 recipients) for human T cell leukaemia/lymphoma virus.Three patients acquired hepatitis B during or after hospital admissionbut not through transfusion; 176 (3%) had pre-existing hepatitisB infection. Sixteen (0.29%) patients had hepatitis C, and five(0.09%) had human T cell leukaemia/lymphomavirus.
Conclusions: The current risk of transfusion transmittedinfections in the United Kingdom is very small, though hospitalacquired infections may arise from sources other than transfusion.A considerable proportion of patients have pre-existinginfections.

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Rapid Responses:

Read all Rapid Responses

Transfusion risk underestimated.: Chris Cowie
bmj.com, 2 Mar 2000 [Full text]
Systematic underestimation of transfusion risks?: Gregor Caspari
bmj.com, 8 Mar 2000 [Full text]
SCREENING FOR HTLV-I - WHY WAIT ?: Tony Pagliuca
bmj.com, 27 Mar 2000 [Full text]