Blood transfusion safety in the country of Georgia: collateral benefit from a national hepatitis C elimination program

Transfusion. 2020 Jun;60(6):1243-1252. doi: 10.1111/trf.15815. Epub 2020 May 4.

Abstract

Background: In April 2015, the government of Georgia (country) initiated the world's 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Blood Safety*
  • Blood Transfusion*
  • Donor Selection
  • Female
  • Georgia (Republic) / epidemiology
  • Hepacivirus*
  • Hepatitis B Surface Antigens / blood
  • Hepatitis C / blood*
  • Hepatitis C / epidemiology
  • Hepatitis C Antibodies / blood*
  • Humans
  • Male
  • Middle Aged
  • Syphilis / blood
  • Syphilis / epidemiology
  • Treponema pallidum

Substances

  • Biomarkers
  • Hepatitis B Surface Antigens
  • Hepatitis C Antibodies